The Efficacy of Education as an Intervention for Improving Core Outcome Domains in People With Tendinopathy: A Systematic Review With Meta-analysis

OBJECTIVE: To evaluate the efficacy of standalone education for people with tendinopathy. DESIGN: Intervention systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE, CINAHL, SPORTDiscus, and EMBASE (from inception to June 2024). STUDY SECTION CRITERIA: Randomized controlled trials (RCTs) comparing standalone education to another intervention for adults with tendinopathy. DATA SYNTHESIS: Outcome (success/no success), pain, and function data were extracted in the short (≤3 months), medium (3-6 months), and long term (≥12 months). Homogeneous data were pooled using random effects and subgrouped by tendinopathy. Continuous and dichotomous data were used to calculate standardized mean differences and odds ratios (ORs) with 95% confidence intervals (CIs), respectively. RESULTS: Eleven RCTs involving 2094 people with tendinopathy were included. Education delivery mode and content varied substantially. There was very low– to low-certainty evidence that education was equivalent to physiotherapy management for short- (OR, 0.56; 95% CI: 0.31, 1.01), medium- (OR, 0.42; 95% CI: 0.12, 1.53), and long-term (OR, 0.56; 95% CI: 0.21, 1.51) treatment success. There was very low– to low-certainty evidence that education was equivalent to corticosteroid injection for short- (OR, 0.32; 95% CI: 0.14, 2.31), medium- (OR, 1.76; 95% CI: 0.18, 17.54), and long-term (OR, 1.86; 95% CI: 0.71, 4.84) treatment success. There was very low–certainty evidence that education combined with physiotherapy management offered no additional benefit for short- (OR, 0.54; 95% CI: 0.07, 4.16), medium- (OR, 0.47; 95% CI: 0.12, 1.81), and long-term (OR, 0.56; 95% CI: 0.21, 1.46) treatment success. CONCLUSION: The short-term benefits of additional treatment to standalone education were not carried through into the medium- and long-term. Education as a standalone treatment could be considered as part of shared decision making for adults with tendinopathy. J Orthop Sports Phys Ther 2025;55(8):538-552. Epub 19 June 2025. doi:10.2519/jospt.2025.13196