Biceps Tendinitis

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[edit] Biceps Tendinitis

Repetitive overhead lifting in front of the body puts a special strain onto the biceps tendon where the long head tendon inserts into the rotator cuff. Everything that was said above about "shoulder impingement", "rotator cuff tendinitis" and "rotator cuff tear" is applicable here.

If the biceps tendinitis is severe and chronic enough, the brittle tissue will eventually break and a rotator cuff tear at the insertion site of the biceps tendon into the rotator cuff will result. The key to the diagnosis is the observation that there is pain in the front part of the shoulder with activity and with resisted forward flexion, particularly in the overhead position.

An MRI scan at this stage may show the biceps tendinitis, or the complete tear of the rotator cuff. In the case of a biceps tendinitis the physician likely will order modified work duties or advise the patient to take a break from the strenuous sports activity. Often with modified activities, utilization of other muscles and physiotherapy treatments it is possible to cure the tendinitis.Topical non-steroidal anti-inflammatories such as Pennsaid can be applied to the skin over the location where there is a in tendinitis this topical medication can penetrate considerably deep into the tissues, deep enough to reach the inflamed tendons. This preparation is a mixture of the anti-inflammatory Diclofenac (1.5%) and the vehicle DMSO, which also has anti-inflammatory properties. The doctor can even order compounded medicine that a pharmacist will mix with Lecithin and 5 to 10% Diclofenac, which is used as a cream or patch using saran wrap (Ref.7).

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References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999.

2. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999.

3. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders

4. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

5. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier

6. Wheeless' Textbook of Orthopaedics: http://www.wheelessonline.com/ Several topics can be found under this link by entering the term you search for.

7. Dr. Taunton, Professor at the University of BC, Vancouver, and Sportsmedicine Director of the Allan McGavin Sports Medicine Centre in Vancouver at the 50th Annual St. Paul's Hospital Continuing Medical Education Conference for Primary Physicians, Nov. 16 - 19, 2004