Long Head of Biceps Brachii Tendinopathy
Conditions
Brief summary
This randomized clinical trial compared ultrasound-guided triamcinolone injection and transcutaneous electrical nerve stimulation (TENS) in patients with long head of the biceps brachii tendinopathy. Participants in both groups also received a supervised physiotherapy exercise program. Pain, shoulder-related pain and disability, ultrasonographic findings, and clinical test results were assessed at baseline and at 1 and 3 months after treatment.
Interventions
DEVICETranscutaneous Electrical Nerve Stimulation (TENS)
Conventional transcutaneous electrical nerve stimulation (TENS) was applied at a frequency of 200 Hz and a pulse duration of 200 μs for 15 minutes per session, for a total of 15 sessions.
DRUGTriamcinolone Acetonide and Lidocaine Hydrochloride
A single ultrasound-guided peritendinous injection of 1 mL triamcinolone acetonide (40 mg/mL) mixed with 1 mL lidocaine hydrochloride (20 mg/mL) was administered around the long head of the biceps tendon.
Sponsors
Gaziler Physical Medicine and Rehabilitation Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
19 Years to 74 Years
Healthy volunteers
No
Inclusion criteria
* Age \>18 years and \<75 years. * Provision of written informed consent. * Long head of the biceps brachii tendinopathy confirmed by ultrasonography (USG) or magnetic resonance imaging (MRI). * Shoulder pain lasting longer than 1 month. * Failure of previous medical treatment.
Exclusion criteria
* Long head of the biceps brachii tendon rupture confirmed by ultrasonography (USG) or magnetic resonance imaging (MRI). * Wound and/or infection at the intervention site. * Steroid injection for the same diagnosis within the previous 3 months. * Known allergy to triamcinolone and/or lidocaine. * Sensory impairment in the shoulder or upper extremity. * Uncontrolled diabetes mellitus. * Diagnosis of epilepsy. * Full-thickness rotator cuff tear confirmed by ultrasonography (USG) or magnetic resonance imaging (MRI).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Scale (VAS) for Pain | Baseline, 1 month, and 3 months | Pain intensity was assessed using a 10-cm Visual Analog Scale (VAS). Pain was evaluated both at rest and during movement. Scores range from 0 (no pain) to 10 (worst imaginable pain), with higher scores indicating greater pain intensity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Shoulder Pain and Disability Index (SPADI) | Baseline, 1 month, and 3 months | Shoulder pain and disability were assessed using the Shoulder Pain and Disability Index (SPADI), which includes pain and disability subscales. The total score ranges from 0 to 100, with higher scores indicating greater shoulder pain and disability. |
| Maximum diameter of the long head of the biceps tendon | Baseline, 1 month, and 3 months | The maximum diameter of the long head of the biceps brachii tendon was measured by musculoskeletal ultrasonography at the site of greatest tendon thickness and recorded in millimeters (mm). |
| Peritendinous fluid around the long head of the biceps tendon | Baseline, 1 month, and 3 months | Peritendinous fluid was measured by ultrasonography at the site of greatest effusion between the tendon and tendon sheath and recorded in millimeters (mm). Minimal probe compression was applied during measurement. |
| Increased vascular signal in the long head of the biceps tendon | Baseline, 1 month, and 3 months | Vascular signal in the long head of the biceps tendon region was assessed using Doppler ultrasonography. Any increase in vascular signal detected along the bicipital groove was considered positive. The result was recorded as positive or negative. |
| Speed Test | Baseline, 1 month, and 3 months | The Speed test was used to evaluate pathology of the long head of the biceps tendon. Test results were recorded as positive or negative. |
| Yergason Test | Baseline, 1 month, and 3 months | The Yergason test was used to evaluate pathology of the long head of the biceps tendon. Test results were recorded as positive or negative. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORYasin Demir, MD
University of Health Sciences Türkiye, Gülhane Faculty of Medicine
Outcome results
None listed