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They are best viewed as part of a broader treatment plan that may include: Physical therapy Activity modification Home exercises Anti-inflammatory strategies Other regenerative or orthopedic treatments when appropriate Repeated steroid injections should also be used carefully, as excessive use may affect tendon and cartilage health over time

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Supplementing with this is a very effective treatment for B12 deficiencies commonly found in patients who suffer from diseases or have nutritional deficits (such as ultra low calorie diets)