The biceps are one of the muscles that run between the shoulder and elbow. A variety of factors can cause lower bicep pain, such as biceps tendonosis, a torn tendon, and delayed onset muscle soreness (DOMS).

Biceps bend the elbow and twist the forearm so that the palm faces upwards. They also help raise the arm overhead. Tendons are cord-like bands of tissue that connect muscles to bones. One possible cause of pain in the biceps is biceps tendonosis.

In this article, we examine the causes of lower biceps pain and potential treatments. We also look at how to prevent lower biceps pain.

Adult male shoulder with right are slightly stretching out to the side and facing forward with the palm almost facing upward. During movement a person may notice lower biceps pain.Share on Pinterest
Image credit: Getty Images

There are various causes of biceps pain, including:

Biceps tendonosis

Biceps tendonosis happens when the bicep tendon weakens. Some people do not feel pain with biceps tendonosis. Others, however, might notice a dull or sharp pain near the front of the elbow in the forearm.

Tendonosis may lead to partial tendon tears or a complete tendon rupture. Therefore, it is important a person who has pain near their elbow seek medical advice.

Biceps tendonosis can happen on its own due to aging, or it may happen after someone lifts something heavy, such as furniture. People who lift weights may be at risk, especially those who perform “negative” exercises, where weightlifters extend the lower arm as they hold weights in their hands.

If a person experiences a complete break of the tendon, it will get worse as time passes and will not reattach to the bone.

Doctors may carry out imaging tests, such as X-rays, MRI scans, or an ultrasound.

Surgery may not be necessary to treat biceps tendonosis. However, doctors may recommend it in some circumstances. Without surgery, a person may be more likely to experience permanent weakness in that arm.

Torn tendon

Sometimes, the tendon that connects the bicep’s muscle to the lower arm can rupture or tear. This may happen because of wear and tear. or while weightlifting or moving heavy boxes, for example.

Symptoms of a torn tendon include:

  • sudden pain around the front of the elbow that does not go away
  • a popping sensation at the front of the elbow
  • swelling around the elbow
  • warmth in the elbow
  • muscle spasms
  • popeye deformity

A distal biceps tendon tear usually happens because of a sudden injury. These tears do not often indicate an underlying condition.

Forcing the elbow straight against resistance is the most common cause of biceps tears. Less commonly, people can injure this tendon by forcibly bending the elbow against a heavy load.

Surgery is the only treatment for a ruptured tendon. During surgery, a doctor will either repair or reattach the damaged tendon. However, sometimes, in certain situations, such as with older adults, the tendon may not be fully repaired.

A person will usually be able to use their hand straight away after surgery. However, they will have to wear a sling for a few weeks afterward.

Doctors typically recommend physical therapy, including stretches and exercises, to help with rehabilitation.

Delayed onset muscle soreness (DOMS)

Many people experience DOMS after working out. DOMS usually happens when someone either starts or expands their exercise regime. It can affect any muscle in the body, including the biceps.

Typical symptoms of DOMS include:

  • pain and soreness in the affected muscle or muscles
  • pain when straightening the arm or carrying heavy objects
  • experiencing similar aches and pains in other muscles

DOMS tends to begin within 24–48 hours of the triggering activity. It usually improves on its own within a few days to a week.

Massage and rest may help to reduce the duration of the symptoms.

Tendonitis is the most common cause of pain in the lower biceps. Usually, biceps tendonitis will get better with rest, ice packs, and over-the-counter pain medication.

If the pain does not improve, a person should speak to a doctor. Doctors may prescribe stronger medications, such as steroid injections, which can help to reduce the irritation.

Pain that comes on suddenly or during an accident or an activity may be a symptom of a ruptured tendon. If someone suspects they have a torn biceps tendon, they should speak to a doctor.

Repetitive movements and exercises are usually the cause of biceps tendinitis, and the lower part of the biceps tendon can rupture after a sudden traumatic injury.

However, there are things people can do to reduce the likelihood of tendon injuries, such as:

  • always warming up before exercising
  • always stretching after exercising
  • taking regular breaks from repetitive exercises or activities
  • avoiding overexercising tired muscles

To help prevent DOMS, people can try:

  • starting new exercise programs slowly, building up the intensity over time
  • always warming up before exercising
  • always stretching after exercise

The most common cause of pain in the lower biceps is irritation in the biceps tendon.

Biceps tendonitis can happen to anyone. General wear and tear might cause it. Biceps tendonitis will usually get better by itself in a week or so.

Sometimes, the tendon can tear or rupture. It will usually start as a popping or painful sensation in the biceps near the elbow. When this happens, people should contact a doctor.

DOMS is another cause of biceps pain after a workout. The pain will usually go away within a week.

Anyone in severe pain or thinks they may have ruptured a tendon should speak to a doctor as soon as possible.