Reference

The primary cause of tendinopathies is degeneration rather than inflammation. This conclusion is supported by several sources, including a study titled "Pathogenesis of tendinopathies: inflammation or degeneration?" published in PMC [1], which discusses the clinical relevance of intratendinous degenerative changes. Another study in the journal Rheumatology mentions that tendinopathy is often degenerative rather than inflammatory in nature [2]. Furthermore, a review article in Wiley's "Chronic tendinopathy tissue pathology, pain mechanisms, and responses to load" also supports the idea that most histologic findings in tendinopathy represent chronic degeneration [3]. The term "tendinosis" is used to describe tendon degeneration, and "tendinitis" is now considered less accurate because inflammatory cells are rarely present in common tendinopathies [4]. Therefore, based on the current understanding and research, degeneration is the primary cause of tendinopathies.