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Typically steroids will provide a short-term benefit, and for some patients this window of pain relief allows them to rehab the tendon and the pain resolves

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The failure of antioxidant systems, particularly glutathione peroxidase 4 (GPX4), which reduces lipid hydroperoxides to non-toxic lipid alcohols, leads to the collapse of membrane integrity and ferroptotic cell death ( A central regulator of ferroptosis and oxidative stress responses is nuclear factor erythroid 2-related factor 2 (Nrf2), a transcription factor that controls the expression of a wide array of antioxidant and cytoprotective genes