Bicipital Tendinitis is a painful condition involving the top of the shoulder.  It is an inflammatory condition of one of the tendons of the biceps, a muscle in the upper arm.  Bicipital tendonitis usually occurs from overuse, such as from pitching a baseball, swimming or playing racquetball.  The pain is usually worse with motions, especially over the head activities such as lifting.  The point of maximal tenderness is the bicipital groove, which is  a point on the upper arm where the tendon is found.  Yergason’s test is a specific provocative test that your doctor can do in his office to see if bicipital tendonitis is a cause of the pain.  Bicipital tendinitis often co-exists with rotator cuff disease.  X-rays are useful to excluded other causes of pain.  MRI scans may be able to more accurately image the problem.  Treatment of bicipital tendinitis begins with conservative modalities such as heat, ice, physical therapy and non-steroidal anti-inflammatory medications.  Phonophoresis and iontophoresis are methods to deliver medications to the area without injections.  In cases of persistent pain,  injection into the area with a dilute solution of a local anesthetic and a steroid may alleviate pain as well.