What Is a Bicipital Tendon Injection?

The biceps muscle is located on the front of the upper arm and has two tendons known as the bicep tendons (bicipital tendon) that attach it to the bones of the shoulders. The long head of the muscle attaches to the top of the shoulder socket. The short head of the biceps attaches to the bone of the shoulder blade.

Inflammation (swelling) of the long head of the bicep tendon is known as bicipital tendonitis. As tendonitis develops, the covering of the tendon (tendon sheath) can thicken. Damage to the tendon can result in tendon tear and deformity of the arm. Other conditions associated with biceps tendinitis are

• Diabetes mellitus
• Long-term untreated Hypothyroidism 
• Arthritis of the shoulder joint
• Injuries to the tissue surrounding the shoulder socket
• Dislocation of shoulder
• Degenerative alteration in a shoulder joint in which there is excessive friction between joint tissues
• Diseases that cause inflammation of the shoulder lining

Taking injections should be avoided in the following conditions:

• Infection of the overlying skin
• Presence of a bleeding disorder
• Severe low blood platelet count
• Infection of the muscular and skeletal system
• Uncontrolled diabetes mellitus

You will be made to sit with hands on the lap; you need to relax your shoulders and neck. The doctor identifies the site of injection, marks the site, and sterilizes it with ethyl alcohol. The doctor fills the syringe with a local anesthetic and corticosteroid. Next, the doctor inserts the needle in the marked area. After inserting the needle, the physician injects the corticosteroid. Once the steroids are injected, the physician withdraws the needle. An ultrasound may be used to guide the needle towards the tendon.

You need to consider the following aftercare instructions:

• Complete rest for one to two days.
• Keep the injected area dry and clean.
• Apply ice packs for 15 minutes every four to six hours on the shoulder.
• Take acetaminophen in case of pain or soreness.
• Avoid lifting anything heavy for 30 days after the injection.
• Avoid regular activities, workouts, and sports, until fully recovered.
• Repeat the injection, if the improvement rate is less than 50% after 8 to 12 weeks.
• Consult the doctor if the symptoms persist for more than three months.

The most prominent issue of bicipital tendon injection is infective arthritis. Other complications include:

• Infection
• Tendon rupture or tear
• Cigarette-paper like skin (repeated injections or faulty injection technique)
• Ecchymosis (discoloration of the skin due to bruises)
• Chronic pressure pain
• Osteoporosis (brittle bones)
• Nerve damage
• Chronic pain