Greater Trochanteric Pain Syndrome

This condition involves the tendons and bursae around the greater trochanter. (bony prominence on the outer hip region) It can be caused by a trauma such as a fall on the side or sports contact injury, repetitive movements such as walking or running, unaccustomed vigorous exercise, standing on one leg for long periods or hip instability. It is characterised by pain on the outer aspect of the hip aggravated by walking or running and lying on the affected side. It may gradually worsen over time if the aggravating factors are not avoided, or treatment has proven ineffective.

Conservative treatment usually involves protection and restoration of full range of motion as well as a reduction in symptoms before improving, function and strength. A gradual return to sport or activity is advised was pain and full function is restored due to the risk of reoccurrence. Injection therapy may be a possible treatment option if conservative treatment has failed. Shockwave therapy may also be a possible treatment option for greater trochanteric pain syndrome especially in the chronic stage of the condition if all other conservative treatment options have failed.

A randomised control trial performed 2009 comparing the home training, corticosteroid injection therapy and shockwave therapy for the treatment of greater trochanteric pain syndrome. They concluded that both home training and shockwave therapy were more effective in reducing pain levels after a 15 month follow-up period compared to a single corticosteroid injection. They also found that shockwave therapy was more effective than both home training and injection after a 4 month follow-up period. They also found that a corticosteroid injection had the best short-term effects.

A systematic review published in 2017 also suggested that shockwave therapy has very limited evidence for the treatment of greater trochanteric pain syndrome but may be considered as a possible treatment option for chronic trochanteric pain with the possibility of long-term effects.

References

  • Rompe JD, Segal NA, Cacchio A et al. Home training, local corticosteroid injection or radial shock wave therapy for greater trochanteric pain syndrome. Am J Sports Med. 2009;37(10):1981-90.
  • Barratt PA, Brookes N, Newson A. Conservative treatments for greater trochanteric pain syndrome: a systematic review. Br J Sports Med. 2017;51(2).