Näytönastekatsaukset

Effectiveness of education and exercise in the treatment of greater trochanteric pain syndrome (GTPS) compared to wait and see.

Näytönastekatsaukset

3.3.2026

Kalle Saikkonen and Eveliina Heikkala

Level of evidence: C

In a randomized controlled trial «Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, si»1 education and exercise intervention reduced pain intensity of GTPS significantly more compared to wait and see approach. Pain intensity was measured on NRS 0-10 scale at baseline (4.8 vs 4.9), at 8 weeks (1.5 vs. 3.8) and at 52 weeks (2.1 vs 3.2). No serious adverse effects were reported. Quality of evidence is low due to risk of bias, imprecision and indirectness. Applicability of the evidence to Finland is average.

Table 1. Description of the included studies
Reference	Study type	Population	Intervention and comparison	Outcomes	Risk of bias
RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis; NRS=Numerical Rating Scale
«Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, si»1	RCT	Patients with clinically diagnosed GTPS	Exercise vs. wait and see	Primary: Pain intensity at 8 weeks and 52 weeks. Secondary: Clinically important pain reduction at 8 weeks and 52 weeks	High

Table 2. Additional comments for included studies
Reference	Comments
«Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, si»1	Highly specific inclusion criteria. Intensive exercise program with 14 individualized physiotherapy sessions, home training and detailed advice/education. Due to the nature of the interventions blinding could not be performed. Low drop-out rates, no selective reporting. Use of additional treatments varied slightly between groups.

Results

Table 3. Pain intensity on NRS scale of 0-10 at 8 weeks
Reference	Number of studies and number of patients (I/C)	Follow-up time	Reported mean pain (SD) I	Reported mean pain (SD) C	Adjusted mean difference (95% CI)
Level of evidence: low The quality of evidence is downgraded due to risk of bias, indirectness. I=intervention; C=comparison; CI=confidence interval; NRS=Numerical Rating Scale
«Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, si»1	1 (69/69)	8 weeks	1.5 (1.5)	3.8 (2.0)	−2.2 (−2.89, −1.54)

Table 4. Pain intensity on NRS scale of 0-10 at 52 weeks
Reference	Number of studies and number of patients (I/C)	Follow-up time	Reported mean pain (SD) I	Reported mean pain (SD) C	Adjusted mean difference (95% CI)
Level of evidence: moderate/low The quality of evidence is downgraded due to risk of bias, imprecision, indirectness. I=intervention; C=comparison; CI=confidence interval; NRS=Numerical Rating Scale
«Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, si»1	1 (69/69)	52 weeks	2.1 (2.2)	3.2 (2.6)	−1.1 (−1.93, −0.33)

Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. Br J Sports Med 2018;52(22):1464-1472 «PMID: 30385462»PubMed