[Conservative treatment of chronic tendinopathies]

The majority of insertional and noninsertional tendinopathy cases are associated with repetitive or overuse injuries. Certain tendons are particularly vulnerable to degenerative pathology; these include the Achilles and patella tendon, the rotator cuff, and forearm extensors/flexors. Disorders of these tendons are often chronic and can be difficult to manage successfully in the long term. Eccentric exercise has the strongest evidence of therapeutic efficacy. Extracorporeal shock wave treatment, sclerosing agents as well as nitric oxide patches show promising early results but require long-term studies. Corticosteroid and nonsteroidal antiinflammatory medications have not been shown to be effective except for temporary pain relief for rotator cuff tendinopathy. Platelet-rich plasma injections show encouraging short-term results.