The efficacy of gluteal tendinopathy treatments: A systematic review.

Gluteal tendinopathy, a common cause of hip pain over the outer thigh, has been treated with everything from exercise programmes to injections and shockwave therapy, but which approaches actually help has been unclear. This review pulled together randomised controlled trials of reasonable quality and low risk of bias that measured pain and function, comparing different treatments against minimal intervention. Four trials showed some benefit.

Exercise combined with education showed a moderate-strength, medium-sized improvement in pain and function in the short term, though the benefit shrank over time. Corticosteroid injections gave a small short-term pain improvement, platelet-rich plasma injections outperformed corticosteroids for function in the short term, and shockwave therapy showed a large long-term pain advantage over corticosteroids in one trial. The evidence base remains small and too varied in methods to combine statistically, so these findings, while promising, need confirmation from larger, more definitive trials before firm practice conclusions can be drawn.

If you have gluteal tendinopathy, pain on the outer hip that can make walking, climbing stairs or lying on your side uncomfortable, you may wonder what treatments actually work. This review looked at high-quality trials testing exercise, injections, and shockwave therapy for this condition.

Combining exercise with education showed the most consistent benefit for pain and function in the short term, though the improvement became smaller as time went on. Steroid injections helped with pain in the short term too, but only modestly.

Platelet-rich plasma injections, made from your own blood, showed better function results than steroid injections in the short term, and shockwave therapy showed a notably larger pain benefit than steroids over the longer term in one trial. These results come from just a handful of trials, each testing different things in different ways, so while the findings are encouraging for exercise-based approaches in particular, more research is needed before anyone can say definitively which treatment works best or for how long.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review identified four RCTs of medium-to-high quality and low risk of bias (per PEDro and Cochrane RoB 2.0) demonstrating efficacy for gluteal tendinopathy interventions compared to minimal intervention. Methodological heterogeneity precluded meta-analysis, so standardised mean differences with 95% confidence intervals were calculated per study arm rather than pooled.

Exercise and education showed moderate-strength evidence of a medium effect on pain (SMD 0.95, 95% CI 0.58-1.33) and function (SMD 0.91, 95% CI 0.53-1.28) short term, attenuating to small effects medium and long term. Corticosteroid injection showed a small short-term pain effect (SMD 0.51, 95% CI 0.16-0.86).

Platelet-rich plasma outperformed corticosteroid for short-term function (SMD 0.46, 95% CI 0.00-0.91), and focused shockwave therapy showed a very large long-term pain advantage over corticosteroid (SMD 5.77, 95% CI 4.84-6.71), though this estimate derives from a single trial and warrants cautious interpretation given its magnitude. Overall, this is a small evidence base of individual trials rather than pooled data, limiting certainty about comparative and durable effects across interventions.