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Low-Energy Extracorporeal Shockwave Therapy as a Treatment for Greater Trochanteric Pain Syndrome

John P. Furia, MD ; Jan D. Rompe, MD and Nicola Maffulli, MD, MS, PhD, FRCS (Orth), FFSEM (UK)

Published online before print May 13, 2009, doi:10.1177/0363546509333014Am J Sports Med September 2009vol. 37 no. 9 1806-1813

USA

Long-term relief even 1 year after therapy

study-9

Greater trochanteric pain syndrome is often a manifestation of underlying gluteal tendinopathy. Extracorporeal shockwave therapy is effective in numerous types of tendinopathies.

Hypothesis:

Shockwave therapy is an effective treatment for chronic greater trochanteric pain syndrome. 

Study Design:
Case control study; Level of evidence, 3.

Methods:

Thirty-three patients with chronic greater trochanteric pain syndrome received low-energy shockwave therapy (2000 shocks; 4 bars of pressure, equal to 0.18 mJ/mm2; total energy flux density, 360 mJ/mm2). Thirty-three patients with chronic greater trochanteric pain syndrome were not treated with shockwave therapy but received additional forms of nonoperative therapy (control). All shockwave therapy procedures were performed without anesthesia. Evaluation was by change in visual analog score, Harris hip score, and Roles and Maudsley score.

Results:

Mean pretreatment visual analog scores for the control and shockwave therapy groups were 8.5 and 8.5, respectively. One, 3, and 12 months after treatment, the mean visual analog score for the control and shockwave therapy groups were 7.6 and 5.1 (P < .001), 7 and 3.7 (P < .001), and 6.3 and 2.7 (P < .001), respectively. One, 3, and 12 months after treatment, mean Harris hip scores for the control and shock wave therapy groups were 54.4 and 69.8 (P < .001), 56.9 and 74.8 (P < .001), and 57.6 and 79.9 (P < .001), respectively. At final follow-up, the number of excellent, good, fair, and poor results for the shock wave therapy and control groups were 10 and 0 (P < .001), 16 and 12 (P < .001), 4 and 13 (P < .001), and 3 and 8 (P < .001), respectively. Chi-square analysis showed the percentage of patients with excellent (1) or good (2) Roles and Maudsley scores (ie, successful results) 12 months after treatment was statistically greater in the shock wave therapy than in the control group (P < .001).

Conclusion:

Shockwave therapy is an effective treatment for greater trochanteric pain syndrome.

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