**4. Systemic medications**

It is unclear if there is a true inflammatory element to rotator cuff tendinopathy and whether non-steroidal anti-inflammatory drugs (NSAIDs) will address this pathophysiology [57]. Currently, no trial or study has been conducted for evaluating NSAIDs as an oral preparation or topically, or other analgesics specifically, for efficacy in the treatment of complete RCTs. Only investigations for shoulder pain in general have been conducted [43]. One metaanalysis of 12 studies concludes that oral NSAIDs can lead to a reduction in pain in individuals with rotator cuff tendinopathy, but there are gastrointestinal or cardiovascular-associated risks [58].
