Distal Biceps Tendinopathy

Distal Biceps Tendinopathy

This is degeneration (wear and tear) of the tendon that attaches the biceps muscle of the upper arm to the radius bone of the forearm.  This typically causes pain at the front of the elbow that may be made worse by lifting or rotational movement of the forearm.

How is the diagnosis made?

The diagnosis can be made with a careful history and physical examination.  In most cases the pain comes on gradually and gets worse with time.  The pain is felt at the front of the elbow and may be made worse by lifting or rotational movement of the forearm. There may be swelling at the front of the elbow.  Pressing on the tendon will incite pain. An ultrasound or magnetic resonance imaging (MRI) scan will help to confirm the diagnosis.

What is the treatment?

The first line of treatment is modification of activities, rest and physiotherapy (eccentric program) to stretch the tendon. This will work in the majority of cases.

If this treatment does not work or if there is a partial tear of the tendon, biological treatment with an injection of your own blood may be required. This contains a mixture of growth factors (platelet rich plasma-PRP) that can stimulate healing.

In a minority of cases keyhole (bursoscopy) or open surgery to tidy up (debridement) the worn attachment of the tendon may be required.

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