Pain on the outside of the hip – Knowledge

1. What you feel at the hip

The pain sits on the outside of the hip. You can point to it with one finger. It lies right over the bony bump you rest on when you roll onto your side. That bump is called the greater trochanter.

Five situations are typical:

• At night in bed. Lying on the painful side wakes you up. Lying on the other side hurts too, because the upper leg drops inwards.
• Walking and climbing stairs, especially uphill and going up.
• Standing on one leg, for instance when pulling on trousers or socks.
• After sitting for a while and when standing up again, above all with the legs crossed.
• Running and hiking, often only after a certain distance.

The pain frequently spreads down the outside of the thigh, usually as far as the knee. In international medical language the condition is called gluteal tendinopathy or greater trochanteric pain syndrome, GTPS for short. In this article we call it tendon pain at the hip.

One note first: this article does not replace a personal examination. What your doctor decides for your case takes precedence.

2. Where the pain comes from

On the outside of your pelvis lie two muscles that keep your pelvis level while you walk. They are called the gluteus medius and gluteus minimus. Their tendons attach to the greater trochanter. These two tendons are the ones that are overloaded in this condition [2], [27].

A tough band of fibres runs over these tendons, from the rim of the pelvis down past the knee. It is called the iliotibial band. When your leg moves towards the midline of your body, this band tightens and presses the tendons against the bone. Health professionals call that pressure compression. It is the reason why certain positions hurt so reliably (section 8.1).

2.1 What became of "trochanteric bursitis"

For decades this condition was called bursitis at the trochanter. Studies of tissue samples and of images have changed that picture [2]:

• In 20 to 30 out of 100 people with pain at the trochanter, a bursa is enlarged. Usually a tendon change is present at the same time [2].
• In only 2 to 8 out of 100 of these people is the bursa altered on its own, with no tendon finding [2].
• In tissue samples from such bursae, researchers found mainly connective and fatty tissue. Signs of acute or ongoing inflammation were absent [2].
• Redness, warmth and swelling are rare in this condition [2].

What follows for treatment: the tendon needs graded loading. Anti-inflammatory treatment as a first step misses the core of the problem [2], [26].

2.2 The gluteal muscles are weaker on both sides

An Australian study compared 50 people with one-sided tendon pain at the hip and 50 people of the same age and sex without symptoms [16]. The strength of moving the leg outwards was measured.

On the painful side, strength was 32 percent below that of the comparison group. On the pain-free side it was 23 percent below [16]. So the strength is missing on both sides.

Whether the weakness was there before the pain remains open. For your training it follows that both sides need exercising.

3. How common is it, and who gets it?

In a Dutch general practice covering 10,651 person-years, all lower-limb tendon conditions of one year were counted [5]. Per 1,000 people per year there were:

• 4.2 cases of tendon pain at the hip, of which 3.3 were new
• 2.4 cases of heel pain (plantar fasciopathy)
• 2.4 cases of Achilles tendon pain
• 1.6 cases of jumper's knee
• 1.2 cases of tendon pain in the groin

The hip therefore comes first. Tendon pain at the hip is the most common tendon condition of the leg seen in general practice [5].

An American population study examined 3,026 people aged between 50 and 79 years [6]. The researchers found tenderness at the trochanter in:

• 24 out of 100 women (15 one-sided, 9 on both sides)
• 9 out of 100 men (7 one-sided, 2 on both sides)

Women are therefore affected about three times as often. In the largest treatment study on this topic, 167 of 204 participants were women and the average age was 55 years [1].

3.1 Men, younger women and runners are affected too

The label "women after the menopause" fits the largest group. It misleads when doctors overlook the condition in other people for that reason [2]. Equally affected are:

• Men. In the largest treatment study, 37 of the 204 participants were men [1].
• Younger women after giving birth who return to sport. During breastfeeding the oestrogen level falls temporarily [2].
• People with hip osteoarthritis and people after a hip replacement. After such an operation, between 2 and 22 out of 100 people reported this condition, depending on the study [2].
• Runners, often after a rapid increase in distance or pace [27].

4. What the condition means day to day

An Australian study compared three groups: 42 people with tendon pain at the hip, 20 people with advanced hip osteoarthritis and 23 people without symptoms [7]. Quality of life and limitation were affected to a similar degree in both pain groups.

For full-time work the proportions were [7]:

• Without symptoms: 68 out of 100 people in full-time work
• With advanced hip osteoarthritis: 52 out of 100
• With tendon pain at the hip: 29 out of 100

This condition therefore weighs more heavily than its name suggests. The groups were small, though. The exact figures are correspondingly uncertain.

4.1 These activities suffer most

In an analysis of the baseline data of 201 participants, each person named the three activities they missed most [8]. Together this gave 585 entries across 34 categories. Named most often were:

• Walking by 68 out of 100 people
• Running by 27 out of 100 people
• Sitting by 27 out of 100 people

On average, participants rated their activities at 4.6 out of 10 points [8]. Here 10 points means the ability before the condition began. Three out of four participants were moderately to highly physically active. The condition therefore affects active people.

4.2 Sleep suffers, and that increases the pain

An Italian study surveyed 62 women with this condition [10]. Half of them slept six hours or less. On a questionnaire about sleep quality the median was 9 points; from 6 points upwards sleep counts as poor. Pain was higher in the evening than in the morning and afternoon.

In a survey of 20 experts from seven countries, sleep counted as one of the most important markers of progress [4]. Better sleep lowers the level of pain. How to achieve that is in section 8.7.

4.3 Persistent pain weighs on your mood

One study compared 40 people with persistent pain at the trochanter and 58 people without symptoms [9]. Those affected reported poorer quality of life, more low mood and more anxiety.

Do mention this. Worry and tension belong in the treatment just as the exercises do.

5. How we work out where the pain comes from

Pain on the outside of the hip can come from several sources: from the tendons, from the hip joint, from the lower back or from a nerve [2]. Telling them apart works through the conversation and a few hands-on tests.

Tenderness at the trochanter, pain when lying on your side and pain when standing on one leg all point to the tendons [2].

Deep pain in the groin, pain in the buttock and stiffness point to the hip joint. Anyone who struggles to put on shoes and socks or to cut their toenails is more likely to have hip osteoarthritis [2].

A broad, deep ache across the back and buttock and pain on bending and lifting point to the lower back. Symptoms spreading into the lower leg and foot and a pins-and-needles feeling point there as well [2].

5.1 The tests we carry out at the hip

A systematic review pooled six studies with 272 people and 314 hips [11]. It calculated how far individual tests shift the probability. The starting point was a pre-test probability of 59 out of 100.

• No tenderness at the trochanter and no pain on resisted hip abduction. The probability falls from 59 to 14 out of 100 [11].
• Tenderness at the trochanter and pain on resisted hip abduction. The probability rises from 59 to 96 out of 100 [11].
• Tenderness at the trochanter and pain in the 30-second single leg stance. The probability rises from 59 to 99 out of 100 [11].

Tenderness alone is of little use for the diagnosis. Many people without symptoms are sensitive there too [2]. The certainty of these figures ranges from very low to moderate, because the studies were small [11].

In the large treatment study, participants additionally had to report pain on the outside of the hip in at least one of six tests [15]. These include the 30-second single leg stance and positions in which the leg is brought towards the midline of the body.

6. What an MRI shows and what it settles

Changes in the gluteal tendons are common on images, including in people without pain.

One study of women found tendon changes on MRI in every woman with symptoms. Among the women without symptoms, these changes were found in 88 out of 100 [12]. In people over 45 without symptoms the proportion lies between 50 and 88 out of 100, depending on the study [2].

A finding on the image therefore proves little. An unremarkable image, on the other hand, argues fairly well against this diagnosis [2].

All 204 participants in the large treatment study had an MRI. A later analysis of these images showed [13]:

• In 130 out of 202 people, both tendons were altered.
• In 85 out of 202 people, a tear was found in one or both tendons.
• Of 99 tears, 77 went only part way through the tendon and 22 went through its full thickness.
• In 73 out of 202 people, the x-ray showed calcium deposits.

The decisive finding of that analysis: pain, function and disability were not related to the extent of the changes on the images [13]. Those with more marked image findings had neither more pain nor a poorer outlook because of it.

Imaging is therefore worthwhile in three situations [2]. The diagnosis stays unclear. Treatment runs differently from expected. There are signs of another cause.

6.1 When the report says "tear"

The word tear frightens many people. It describes one stage of a slow change that runs from tendon damage through a partial tear to a full-thickness tear [2].

Partial tears are common in people over 50, and they rarely progress further [2]. Even a tear through the full thickness of the tendon often affects only a small part of its width.

In the large treatment study, 85 of the 202 participants examined had a tear [13]. They went through the same treatment without surgery. The extent of the tendon damage did not change the treatment outcome [2].

So if your report says "tear", that is no instruction to operate. When surgery does come up for discussion is in section 11.

7. What happens without treatment

The sentence "it will settle by itself" applies to only some of those affected.

In the large treatment study, one of the three groups received a single advice session and then waited [1]. Out of 100 people in this group:

• after 8 weeks, 29 out of 100 reported a marked improvement
• after 52 weeks, 52 out of 100 reported a marked improvement

After one year, roughly half of this group was markedly better. The other half was not.

A small Australian study followed 24 people with this condition and 20 people without symptoms over eleven years [14]. After eleven years, among those still reachable:

• 9 out of 20 from the symptom group were still affected, compared with 1 out of 19 from the comparison group
• 7 out of 20 from the symptom group had been diagnosed with hip osteoarthritis, compared with no one from the comparison group

The groups were small, and the authors themselves urge caution [14]. The link between this tendon condition and later hip osteoarthritis is still open.

8. What helps

The answer to this question comes above all from an Australian study published in the British Medical Journal in 2018 [1]. It is called the LEAP trial. We describe it at length here because it has changed treatment worldwide.

204 people aged between 35 and 70 took part. All had pain on the outside of the hip for at least three months, on average at least 4 out of 10 points. In all of them an MRI confirmed the tendon change. Chance assigned them to three groups [1]:

1. Education and exercise: 14 physiotherapy appointments over eight weeks, plus a daily home programme
2. Corticosteroid injection: one single injection under ultrasound guidance, plus a short advice session
3. Wait and see: one single advice session

After eight weeks, a marked improvement was reported by [1]:

• 77 out of 100 from the education and exercise group
• 58 out of 100 from the corticosteroid injection group
• 29 out of 100 from the group that waited

After 52 weeks, a marked improvement was reported by [1]:

• 78 out of 100 from the education and exercise group
• 57 out of 100 from the corticosteroid injection group
• 52 out of 100 from the group that waited

Pain in the past week was recorded on a scale from 0 to 10. After eight weeks it averaged 1.5 points (education and exercise), 2.7 points (injection) and 3.8 points (waiting) [1]. After 52 weeks the values were 2.1, 2.3 and 3.2 points.

A systematic review from 2025 searched five databases for studies of good quality [3]. It found four effective treatments from four studies. Education and exercise had the strongest evidence among them [3].

8.1 These positions press on the tendon

The first part of the treatment costs nothing and starts today. It consists of lowering the pressure on the tendons. That pressure rises whenever your thigh moves towards the midline of your body [2], [27].

Lying down:

• Sleep on the pain-free side or on your back.
• On your side, place a firm pillow between knee and ankle. That keeps the upper leg level with the hip.
• On your back, place a flat pillow under your knees.

Sitting:

• Place both feet side by side on the floor, knees about hip-width apart.
• Choose a higher seat, so that your knees sit lower than your hips.
• Stand up in between after sitting for a while.

Standing:

• Spread your weight over both feet.
• Keep your pelvis level rather than sinking into one hip.

Walking:

• Place your feet in two tracks, about hip-width apart.
• Increase distance and pace slowly, by no more than about 10 percent a week [2].

This advice was part of every effective study [1], [17], [18]. In the survey of 20 experts it counted as the part that those affected can put into practice fastest themselves [4].

8.2 The exercise programme from the LEAP trial

The LEAP programme is published in full in the trial protocol [15]. It comprises four to six exercises and takes 15 to 20 minutes a day.

Week 1, getting used to it. All exercises slow and at light effort:

• Holding without movement: lying on your back, press the legs outwards against a belt or against your hands. Hold 5 to 10 seconds, 3 to 5 repetitions, twice a day. The same standing up, 5 to 15 seconds.
• Bridge: lying on your back, lift the pelvis with both feet. 10 repetitions, once a day.
• Squat: with both legs, as deep as you can with little pain. 10 repetitions, once a day.
• Sidesteps: 10 steps each direction, once a day.

Week 2, first loading. The week 1 exercises stay. Offset versions are added: a bridge and a squat in which one foot stands further forward and the other leg carries more weight. 5 repetitions each. Sidesteps rise to 15 each direction [15].

Weeks 3 to 8, building up. The single-leg-biased exercises take on more weight [15]:

• Single-leg-biased bridge: 5 to 10 repetitions, 2 sets, daily
• Single-leg-biased squat: 5 to 10 repetitions, 2 sets, daily
• Sidesteps with an elastic band: 5 to 10 each direction, 1 to 2 sets
• Twice a week at the clinic: abduction against spring resistance, upright and in a mini squat, 5 to 10 each direction

Effort is steered with a rating scale. The warm-up stays light, the exercises for movement control are moderate to hard, and the heavy strengthening is hard to very hard [15].

In the LEAP trial, participants attended physiotherapy once a week for the first two weeks and twice a week after that [15]. That gives 14 appointments in eight weeks.

That many appointments are hard to obtain in many countries. An Irish study therefore tested the same treatment with only six appointments over eight weeks [20]. 65 people took part and 58 of them stayed to the end. The approach proved practicable. Whether six appointments work as well as 14 will only be answered by the planned large study with 134 participants [20].

A Danish study tested a heavier route: 19 people trained for twelve weeks, two and a half times a week, with heavy and slowly performed exercises [19]. 18 of 19 completed the programme; one person dropped out. No serious side effects occurred. Pain stayed tolerable before, during and 24 hours after the sessions. The group was small and a comparison group was missing [19].

8.3 How much pain is allowed while exercising

The LEAP trial worked with two different rules [15]:

• During the exercises for movement control, such as squat and bridge, pain at the trochanter should not rise at all. A rise shows that pelvis and leg are not yet being guided cleanly.
• During heavy strengthening without pressure on the tendon, up to 5 out of 10 points was allowed. The condition was that the pain settles again afterwards.

The most important rule is the 24-hour rule: in the evening and the next morning, the pain may be at most at the level it was before [2]. If it is higher, the load was too great. Then reduce weight, repetitions or distance.

8.4 How long it takes

The experts in the international survey consistently named twelve weeks of continuous training as the minimum for a recognisable result [4]. For the full rebuilding of strength they named six months to a year.

In the LEAP trial, symptoms improved markedly on average within the eight weeks [1]. The state after 52 weeks was about as good as the state after eight weeks. So the improvement held.

The experts also recommended short, frequent sessions rather than a few long ones [4]. Ten minutes on five days works better than 50 minutes on one day.

8.5 Why stretching the outside makes symptoms worse

For decades a shortened band of fibres on the outside counted as the cause. From that came the advice to stretch it [2].

There is no evidence of such shortening in this condition [2]. The usual stretches bring the leg towards the midline of the body. That very movement presses the tendons against the bone [2], [27].

The same applies to the exercise in which you lie on your side and open and close your knees, known as the clam. This exercise brings the leg repeatedly towards the midline. It featured in none of the treatment studies [2].

Choose exercises in standing with weight on the leg instead. They reach the gluteal muscles more strongly [2]. Why stretching achieves less than expected in general is in our guide on stretching.

8.6 What is still uncertain about this programme

Two studies have tested a targeted exercise programme against sham exercises. Both groups received the same detailed advice on loading.

In the first study, 94 women after the menopause exercised for twelve weeks [17]. Both groups improved markedly at 12 and at 52 weeks. Between the groups no difference was found.

In the second study, 132 women after the menopause additionally received either a hormone cream or a dummy cream [18]. Here too all groups improved. Again no difference was found between the groups.

An honest reading follows from that. What is proven is the package of education, load management and regular exercise compared with waiting [1], [3]. How much any single exercise contributes we do not yet know for certain.

A meta-analysis of three studies with 383 people confirms this picture [30]. Exercise improved function compared with minimal treatment, in the short and the long term. For quality of life no difference was found.

For your everyday life this changes little. You can put the advice into practice at once, and the exercises cost little and do no harm [19].

8.7 How to sleep better

For many people affected, sleep is the most pressing problem [4], [29]. These four points help:

1. A pillow between the knees. It keeps the upper leg level with the hip when you lie on your side.
2. A soft surface on the side you lie on. A mattress topper lowers the pressure on the trochanter.
3. Lying on your back with a pillow under the knees, if lying on the side still hurts.
4. Pain medication in the evening. Ask your doctor about it. In the expert survey, a good night counted as the precondition for everything else [4].

9. What the corticosteroid injection does

The corticosteroid injection works quickly in many people. Its effect wears off.

In the LEAP trial, after eight weeks 58 out of 100 people from the injection group reported a marked improvement. In the waiting group it was 29 out of 100 [1]. After 52 weeks the values were 57 out of 100 against 52 out of 100. The lead had largely disappeared.

A German study with 229 people compared a corticosteroid injection, a home training programme and a shockwave treatment [21]. "Completely recovered" or "much improved" counted as success:

• After 1 month: injection 75 out of 100, shockwave 13 out of 100, home training 7 out of 100
• After 4 months: shockwave 68 out of 100, injection 51 out of 100, home training 41 out of 100
• After 15 months: home training 80 out of 100, shockwave 74 out of 100, injection 48 out of 100

The pattern over time is therefore the same in two independent studies: an early advantage, and later no advantage.

A systematic review of the effect of corticosteroids on tendon tissue also describes possible drawbacks [24]. These include less cell division, less production of collagen and a more disordered fibre structure. These findings come mostly from laboratory and animal experiments.

So the injection keeps a place. It can make sense when your pain is so severe that you cannot start the exercises at all [4]. The experts in the international survey saw it in exactly that role: as a door-opener for the exercises, rather than as a treatment in itself [4].

If you decide on an injection, plan the start of the exercises at the same time.

10. Shockwaves, blood products and hormones

10.1 Shockwaves

The 2025 systematic review found a very large estimate of the long-term advantage of focused shockwave treatment over the corticosteroid injection [3]. That estimate comes from a single study [21], and its size is unexpectedly high for such a treatment.

We therefore take the same line as the authors of the review. Shockwaves are an option once education and exercise have achieved too little after several months [3]. As a first step they are not established.

10.2 Blood products

In platelet-rich plasma treatment (PRP), a doctor injects prepared components of your own blood into the tendon.

An Australian study compared a PRP injection with a corticosteroid injection in 80 people [22]. After twelve weeks, 32 out of 39 people in the PRP group reached a meaningful improvement, compared with 21 out of 37 in the corticosteroid group.

A British study compared the PRP injection with a dummy injection in 79 people [23]. Both groups improved, and the improvement lasted twelve months. Between the groups no difference was found at any time point.

The second study answers the more important question. It shows that the improvement after a PRP injection also occurs without the active ingredient. Little therefore currently speaks in favour of PRP [2], [23].

10.3 Hormones after the menopause

A link between oestrogen and the load tolerance of tendons is plausible. It would explain why women after the menopause are affected so often [2].

The study conducted on this, with 132 women, found no difference between the hormone cream and the dummy cream [18]. All groups improved over twelve weeks.

Hormone treatment for this condition alone is therefore not established. If you are considering it for other reasons, discuss that with your doctor.

11. When surgery comes up for discussion

A systematic review from 2026 searched six databases for studies on the treatment of tears in the gluteal tendons [25]. It found 38 papers covering 1,584 people. All of them examined surgery, and 35 of them were mere case series. No study with random allocation was found.

The results after at least twelve months were favourable. Quality of life improved by 22 to 49 points out of 100 depending on the study, and pain fell by 1 to 7 points out of 10 [25]. The authors rated the certainty of these figures as very low. In 58 out of 100 papers the quality was low.

The review also found not a single study on treating tendon tears without surgery [25]. A comparison between the two routes is therefore still outstanding.

Three findings currently argue for a conversation about surgery [2]:

• a large-area detachment of the tendon from the bone
• a marked drop of the pelvis while walking that does not improve
• a persistently marked loss of strength in hip abduction after at least three months of training

For tendon conditions of the arms and legs in general, experts recommend treating with exercise for at least a year before surgery is considered [2]. That recommendation can be carried over to the hip as long as comparison studies are lacking.

12. What you do yourself

12.1 These five things start today

1. Put a pillow between your knees when you lie on your side. Sleep on the pain-free side.
2. Place both feet side by side on the floor when you sit.
3. Spread your weight over both feet when standing.
4. Leave out stretching of the outside, and the clam exercise in side lying as well.
5. Start with holding without movement (section 8.2). This exercise works lying down and standing up.

12.2 These details are what we need from you

• Where exactly the pain sits. Point to it with one finger.
• How you sleep. On which side, how often you wake up, how long you sleep.
• How far you can walk and at what distance the pain starts.
• How stairs go, up and down.
• What has changed in recent months. A new running programme, a move to a home with stairs, a long illness, an operation on the hip.
• Which treatments you have already had, with dates and effect.

These six details lead to the cause faster than any single test.

12.3 How you see whether the treatment is working

An international expert group set out in 2024 which measures should be taken in this condition [28]. None of the measurement tools examined met all requirements. Until better ones exist, the group recommends these five:

• Your own rating of the overall change since treatment began
• Your pain at night on a scale from 0 to 10
• The time until pain starts in single leg stance, up to 30 seconds
• Your pain when climbing one flight of stairs on a scale from 0 to 10
• Your confidence in doing things despite pain

Note these values at the start. Measure again after six and after twelve weeks. Only the second value shows you whether the programme is working.

13. For health professionals: eight conclusions for practice

This section is addressed to colleagues in physiotherapy and medicine. It summarises how we apply the evidence in our practice.

1. Diagnose with test sequences, not with a single test. Palpation plus painful resisted abduction raises the post-test probability from 59 to 96 out of 100; palpation plus the 30-second single leg stance raises it to 99 out of 100 [11]. The certainty of the evidence ranges from very low to moderate.
2. Weight a negative palpation more heavily than a positive one. Negative palpation plus negative resisted abduction lowers the probability to 14 out of 100 [11].
3. Treat the person, not the MRI report. In the LEAP cohort, pain, function and disability were unrelated to the extent of imaging change [13]. Tendinopathic change is present in 50 to 88 out of 100 symptom-free people over 45 [2].
4. Put compression relief before strengthening. Adduction past the midline generates the compressive stimulus [27]. The clam and iliotibial band stretches featured in none of the effective studies [2].
5. Dose by the 24-hour response. No rise in pain during pelvic control exercises, up to 5 out of 10 during compression-free heavy strengthening [15].
6. Plan for twelve weeks. The international expert survey names twelve weeks as the minimum duration and short frequent sessions as the better distribution [4].
7. Communicate the uncertainty about exercise content. Two controlled studies found no difference between targeted and sham exercises when advice was equal [17], [18]. What is proven is the whole package against waiting [1], [3].
8. Assess sleep and mood in a standardised way. In practice both say more about the course than the palpation finding [4], [9], [10].

To put the evidence in context: the 2025 systematic review found only four treatments with proven efficacy across all randomised studies [3]. The bulk of the efficacy evidence for education and exercise comes from a single trial [1]. A second large trial is still missing.

14. What you should know about this tendon condition

• The pain usually comes from the tendons of the gluteal muscles. An inflamed bursa on its own is present in 2 to 8 out of 100 of those affected [2].
• Education and exercise work best. After 52 weeks, 78 out of 100 people reported a marked improvement. After a corticosteroid injection it was 57 out of 100, and while waiting 52 out of 100 [1].
• The corticosteroid injection works early and loses its lead. After 15 months it came behind home training and shockwave in a second study [21].
• Waiting helps about half of those affected. After a year the other half was still affected [1].
• Pressure on the tendon arises when your leg moves towards the midline. Pillow between the knees, feet side by side, weight on both legs [2].
• Stretching the outside increases exactly that pressure [2].
• Plan for twelve weeks of training, spread over short daily sessions [4].
• A "tear" on the MRI report calls for no operation. 85 out of 202 LEAP participants had a tear and were treated without surgery [13].
• The most informative study argues against PRP. Compared with a dummy injection, no difference was found [23].
• How much any single exercise contributes is open [17], [18].

Start with the positions in section 8.1. Then ask for an exercise programme and for an appointment for the second measurement.

How tendon pain at the shoulder runs is in our guide on shoulder pain. How hip osteoarthritis differs from this is under hip osteoarthritis.

References

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Transparency

• Authorship: Roger Hilfiker
• AI assistance: the literature search and the first draft were produced with Claude (Anthropic). Roger Hilfiker checked every statement, figure and source and revised the text.
• Written: 22 August 2026
• Last updated: 22 August 2026
• Sources: the 30 works in the reference list. All DOIs were checked against the Crossref register.
• Declaration of interest: our practice provides physiotherapy and earns from the treatment this article describes as the most effective one. The figures come from a trial we took no part in [1]. The figures for waiting stand alongside them at the same length.
• Funding: Physiotherapie Tschopp & Hilfiker, 3902 Glis. The practice funded this article from its own means.
• Next review: planned for January 2027