[Biceps long head tenosynovitis]
refers to the degeneration of the tendon due to long-term wear and tear during shoulder movement. Adhesion, the pathological changes of tendon sliding function impairment, more common after the age of 40, there will be pain in the intertuberous groove of the humerus, shoulder joint limitation, and in severe cases, it will develop into frozen shoulder.
【Biceps long head tendon function】
Biceps long head tendon through the humeral tuberosity It enters the anterior part of the subacromial space posteriorly and inserts into the supraglalenoid tuberosity of the scapula. The sliding of the tendon in the intertuberous groove of the humerus is passive, that is, the tendon slides upward when the shoulder joint is adduction, internal rotation, and extension, and slides downward when the shoulder is abducted, externally rotated, and flexed.
[Etiology]
This disease is caused by trauma or strain, degeneration of tendons due to long-term wear and tear .
【Clinical manifestations】
1. Common shoulder pain, obvious at night, aggravated after shoulder activities, and relieved after rest . The pain is localized to the biceps tendon and can also involve the front of the upper arm. Any action that tenses, slides, or stretches the tendon can make the pain worse.
2. Yergason sign,
Appears in the internodal groove when the elbow is flexed against resistance in the supination position of the forearm Pain is the main basis for diagnosis.
That is:
The patient flexes the elbow 90°, and the doctor holds the patient’s elbow with one hand and the wrist with the other hand , instruct the patient to forcefully flex the elbow, abduct, and externally rotate, and the doctor gives resistance. If the biceps tendon slips out, or pain occurs in the intertuberous groove, it is a positive sign. The former is the biceps long head tendon This is biceps long head tendinitis.
3. In the acute stage, the active and passive movement of the shoulder joint may be limited, and the deltoid muscle may appear protective spasm. Chronic illness combined with frozen shoulder can lead to stiffness of the shoulder joint and muscle atrophy.
4. The internodular sulcus is narrowed or shallow, and bone spurs are formed at the bottom or edge of the sulcus.
【How to deal with it? ]
1. Actively see a doctor, make a clear diagnosis, first non-surgical therapy, integrated traditional Chinese and Western medicine, acupuncture, massage and touch, external application of traditional Chinese medicine safflower oil, promote blood circulation and reduce swelling; orally Non-steroidal anti-inflammatory drugs; 2. Partial blocking treatment, inject the suspension of lidocaine and triamcinolone acetonide acetate into the tendon sheath. Under the guidance of musculoskeletal ultrasound, precise release and sealing treatment is performed, which is more precise and effective.
3. Surgical therapy is suitable for individual stubborn cases.
Dr. Zhou Biqiang has been a doctor for 40 years, focusing on spine-related diseases. Every Friday afternoon and Saturday morning, he outpatient neuropain MDT and spinal pain MDT specialist in Shenzhen Second People’s Hospital Sitting for consultation.