Critically appraised paper: Education plus exercise, and corticosteroid injection, are superior to a wait-and-see approach for gluteal tendinopathy [synopsis]

Question: Is education plus exercise, and corticosteroid injection, more effective thanwait and see on global changes in hip conditions and pain in people with gluteal tendinopathy? Design: Multicentre, three-arm randomised controlled trialwith concealedallocation.Setting: Twouniversitydepartments in Australia. Participants: Community-dwelling participants from Brisbane andMelbourne. Inclusion criteriawere age 35 to 70 years, lateral hip pain (. 3 months) of intensity at least 4/10 on a numerical rating scale, and gluteal tendinopathy confirmed by clinical diagnosis and magnetic resonance imaging. Low back, sciatic, or groin pain, corticosteroid injection (previous 12 months), andcurrentphysiotherapytreatmentwereexclusioncriteria.Randomisationof 204 participants allocated 66 to corticosteroid injection, 69 to education plus exercise, and 60 to wait and see. Interventions: Education plus exercise comprised 14 sessionswith a physiotherapist over 8weeks (60minutes initial, otherwise30minutes) and involvededucationon tendoncareand loading, and daily home exercises (hip abductor strengthening; dynamic control of hip adduction). The corticosteroid injections were ultrasound-guided by a radiologist. The wait-and-see approach included one sessionwith a physiotherapist for information about gluteal tendinopathy, risk factors, advice regarding continuation of activity, and reassurance. Outcome measures: Primary outcomes were: global change in hip condition (numerical rating scale),