A patient with a long head biceps (LHB) tendinopathy, which is a pain and/or tearing of the tendon, may also have a shoulder problem and/or a rotator cuff tear. Traditional treatments include both surgical and non-surgical approaches.

“The surgeon’s goal in treating any long head biceps tendinopathy is to address the pain in a way that also respects the patient’s lifestyle. And, as we found, there is a variety of excellent surgical and non-surgical options. In developing this review, we also discovered the need for more comparative research data on surgical versus non-surgical treatment outcomes for this condition,” aaid Shane Nho, MD, an orthopaedic surgeon who practices in Chicago and whose review appears in the November issue of the Journal of the American Academy of Orthopaedic Surgeons.

Some trends and statistics from the report include:

  • Recent studies reported no significant difference in function or patient satisfaction between the two primary surgical options, biceps tenotomy or tenodesis.
  • Each year, an average of 10 million people seek medical attention for a shoulder injury and an average of four million people come in with arm injuries.
  • Both surgical treatments for LHB tendinopathy are statistically successful, with a complication rate of less than one percent.
  • The authors agree that non-surgical treatment is the first – and in many cases may be the only – treatment necessary.
  • The authors of this review seem to agree that of the two surgical options, biceps tenodesis should be used in younger, active patients.
  • The first line of treatment for LHB tendinopathy is a variety of non-surgical options, such as rest, anti-inflammatory drugs, activity modification and physical therapy. If those treatments do not offer the patient relief, a course of corticosteroid injections may be attempted. The authors do, however, report a concern about intratendinous corticosteroid injections, which may predispose the patient to tendon rupture. More research is needed to address this concern.