At this time it is widely accepted among clinicians that chronic tendinopathy is caused by a degenerative process without inflammation. Current treatment strategies are focused on physical treatments, peritendinous or intratendinous injections of blood or blood products and interruption of painful stimuli. Results have been at best, moderately good and at worst a failure. The evidence for non-infammatory degenerative processes alone as the cause of tendinopathy is remarkably weak. There is convincing evidence that the inflammatory response is an essential component of chronic tendinopathy. Newer anti-inflammatory modalities could offer alternative potential opportunities in treating chronic tendinopathies and should be the focus of additional investigation.