Distal Biceps Tendon Disorders

The diagnosis of distal (i.e. insertional) biceps tendonitis has received scant attention in the literature. A search using MESH search terms including “tendonitis” and “biceps” or “arm” or “elbow” failed to capture any primary references from the MEDLINE database in mid March 1998. The entity is mentioned in discussions of elbow problems, but these annotations are unreferenced 1. Therefore, it is impossible to advocate specific therapy for distal biceps tendonitis based on anything but anecdote.

Treatment would be along the lines suggested for tendonitis in general, with rest followed by stretching and graded increase in load. The role of local injection of corticosteroid, or other anti-inflammatory treatments remains intuitively appealing but unsupported by evidence either positive or negative.

Recommendation

In the absence of an evidence-base for either the diagnosis or the treatment of distal biceps tendonitis or triceps tendonitis,

Treatment should be guided by avoiding investigation and expensive unproven modalities.

An initial period of two weeks rest followed by gradual return to full activity is reasonable and falls within generally accepted principles of treatment of painful tendons.