What To Know and Do About Bicep Pain

Bicep pain is felt in the front part of the upper arm and can range from mild discomfort to severe pain. It can result from everyday activities, such as lifting heavy objects or overusing muscles, or be a sign of a more serious issue, such as muscle strain, tendonitis, or a tear in the bicep tendon.

Bicep pain may affect your ability to perform routine tasks or engage in physical activities. Treating it can help relieve discomfort, prevent potential long-term damage, and ensure you maintain full arm function. Recognizing the severity and underlying cause of the pain guides treatment and recovery strategies.

What Structures Are in the Bicep?

The biceps brachii, commonly known as the bicep, is a muscle located in the ventral (front) part of the upper arm. It's primarily responsible for elbow flexion (bending) and forearm rotation. The bicep consists of two muscle heads—short and long—and is attached to bones by tendons.

Structures in the bicep area include:

• Bones: The humerus is the long upper arm bone between the shoulder and the elbow. The radius and ulna are the two forearm bones.
• Tendons: The long and short head tendons connect the bicep muscle to the shoulder and elbow.
• Nerves: The musculocutaneous nerve controls the bicep. It helps the muscles move and allows you to feel sensations.
• Blood vessels: The brachial artery runs close to the bicep, supplying blood to the arm.

Any issues with these surrounding structures can affect the bicep's function and contribute to pain or discomfort.

How Bicep Pain Presents

Bicep pain can present in various ways depending on the underlying cause. Here are some common symptoms:

• Dull ache at rest or night
• Pain that increases with pulling, lifting, or repetitive movements
• Sharp pain that may radiate down the arm
• Tenderness
• Muscle weakness
  
• Reduced range of motion
• Swelling or bruising
• Clicking or popping sound
• Cramping
• Difficulty rotating the forearm (e.g., turning the palm up or down)

It is crucial to address bicep pain promptly to prevent long-term damage and restore normal function.

Potential Causes of Bicep Pain

Various conditions can cause bicep pain. Understanding the underlying cause is necessary for effective treatment.

Biceps Tendinitis

Biceps tendonitis involves inflammation of the tendons connecting the bicep muscle to the shoulder or elbow. This condition typically causes a dull ache in the front part of the arm or shoulder, which worsens with movement and may be sharp during certain activities.

Tendonitis often results from repetitive strain or overuse during physical activities over time. Sports that require repetitive motions, such as swimming, baseball, and tennis, may increase this risk.

Bicep Muscle Strain

A bicep muscle strain, or "pulled muscle," occurs when the muscle fibers are overstretched or torn. Strains are often caused by lifting heavy weights, sudden jerks or pulls, or overstretching the muscle. Risk factors include:

• Older age
• Having less flexibility
• Lack of muscle strength
• Fatigue
• Previous muscle injury
  

Bicep Tendon Rupture

A bicep tendon rupture is a tear in the tendon connecting the bicep muscle to the shoulder or elbow. This condition causes intense pain in the upper arm and a noticeable bulge ("Popeye muscle") where the bicep muscle retracts.

Ruptures are commonly caused by sudden trauma, chronic overuse, heavy lifting, or degenerative changes due to aging. Risk factors include:

• Older age
• Heavy overhead activities
• Shoulder overuse
• Smoking
• Using corticosteroid medications

Rotator Cuff Injury

Rotator cuff injuries primarily affect the shoulder but can cause referred pain in the bicep area. The rotator cuff is a group of muscles and tendons that stabilize the shoulder joint. Pain from a rotator cuff injury often presents as a dull or aching sensation in the shoulder that radiates down the bicep.

Symptoms include decreased arm strength and a clicking or popping sound when you move your arm. Risk factors include:

• Being over 40 years old
• Playing sports with repetitive shoulder movements (e.g., swimming, tennis, baseball)
• Repetitive heavy lifting
• Repetitive overhead reaching

Shoulder Impingement Syndrome

Shoulder impingement syndrome (rotator cuff tendonitis) happens when the tendons in your shoulder get squeezed under a bony part of the shoulder blade called the acromion. This squeezing can make the tendons inflamed and painful, leading to shoulder impingement syndrome.

Shoulder impingement syndrome can be caused by regular shoulder use over time, such as playing sports or an injury.

Bicep Bruise or Contusion

A bicep bruise or contusion results from direct trauma or impact to the bicep area, leading to internal bleeding and swelling within the muscle. The pain is usually sore and dull at the impact site, with additional symptoms such as a bluish discoloration or swelling.

This condition often results from direct impact or trauma, such as falls or bumps.

Humerus Fracture

Causes of a broken humerus include intense physical traumas and falls. They can also result from bone metastasis (advanced stages of cancer). These fractures often cause temporary disability in younger populations, but they can cause permanent disability in older adults.

Symptoms of a humerus fracture include:

• Severe pain (e.g., when trying to lift the affected arm)
• Swelling
• Limited range of motion
• Nerve damage (depending on factors like the location and type of fracture)

When To See a Healthcare Provider

You should seek evaluation from a healthcare provider if your bicep pain persists for more than a few days, worsens over time, or significantly affects your daily activities. You should also reach out if you experience severe pain that interferes with normal movement or pain accompanied by swelling, bruising, or weakness.

Immediate medical attention is necessary if the pain is sudden and intense, especially if you have other symptoms such as:

• Chest pain
• Dyspnea (shortness of breath)
• Dizziness
• Nausea
• Sweating
• Numbness in the arm

These symptoms could indicate a more severe condition, such as a heart attack. Other red flags may include fever, significant swelling, or pain that doesn't improve with rest and over-the-counter (OTC) treatments like pain medication.

How Is Bicep Pain Diagnosed?

Your healthcare provider will ask about the onset and duration of symptoms and activities that might contribute to your pain. They’ll review any previous injuries or medical conditions.

Expect a thorough exam, during which the provider will palpate (touch) the bicep, check for swelling or tenderness, and assess your range of motion and strength.

Imaging tests your provider may order could include:

• X-rays: Uses electromagnetic radiation to provide images of structures like bones
• Magnetic resonance imaging (MRI) scan: An imaging procedure that uses a strong magnetic field and radio waves to generate images of the body
• Ultrasound: An imaging procedure that uses sound waves to generate live images (sonograms) of your organs, tissues, and fluids
• Complete blood count (CBC): Analyzes blood components like red and white blood cells and platelets to detect underlying health conditions that may cause muscle pain

Your provider may refer you to an orthopedic specialist or a sports medicine doctor for further evaluation and treatment if necessary. Both providers specialize in musculoskeletal injuries and conditions, but orthopedists might perform surgery.

How Is Bicep Pain Treated?

A combination of at-home remedies and medical treatments can help alleviate discomfort and promote healing if you’re experiencing bicep pain. Therapies or medical intervention might be required.

At-Home Treatments

You can try several at-home remedies to relieve bicep pain:

• Avoid activities that strain the bicep to allow healing
• Ice the affected area for 15-20 minutes several times daily to reduce swelling and numb the pain
• Use nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) or Tylenol (acetaminophen) to manage pain and inflammation
• Perform gentle stretches to maintain flexibility and alleviate stiffness, but don't overstretch
• Apply heat after the initial swelling has gone down to help relax tight muscles and improve blood flow

Medical Treatments

If at-home treatments are insufficient, the pain persists, or your injury is more serious, your healthcare provider may recommend other medical interventions such as:

• Physical therapy (PT): A physical therapist can provide exercises and techniques to strengthen the bicep, improve flexibility, and prevent future injuries.
• Injections: Corticosteroid injections may reduce inflammation and provide pain relief.
• Surgery: Surgical intervention may be necessary in rare cases of severe injuries, such as a torn bicep tendon or broken bone.
  

A Quick Review

Bicep pain can stem from various causes, including tendonitis, muscle strains, and injuries. Address the pain promptly through rest, ice, and OTC medications to help manage discomfort and aid recovery.

Bicep pain can significantly affect your daily functioning and quality of life. Consult a healthcare provider for a proper diagnosis and treatment plan if you have persistent or severe pain. Understanding the causes and available treatment options can help you take proactive steps to relieve your bicep pain and return to regular activities.