The Benefits of Focused Shockwave Therapy for Greater Trochanteric Pain Syndrome

Effective Management of Greater Trochanteric Pain Syndrome with Focused Shockwave Therapy

Greater trochanteric pain syndrome (GTPS) is a common yet challenging condition affecting the lateral hip region. This multifaceted pain disorder often impacts individuals’ mobility and overall quality of life. While its exact physiopathology remains unclear, recent research offers promising advancements in treatment strategies. A groundbreaking multicenter, randomized controlled trial published in The Journal of Bone and Joint Surgeryhighlights the efficacy of focused extracorporeal shockwave therapy (F-ESWT) combined with targeted exercise for managing GTPS.

In this blog, we’ll delve into the study’s findings, explain the mechanisms behind F-ESWT, and explore how these insights align with the comprehensive care provided at Neurohealth Wellness. Through a holistic approach, we aim to empower patients with tools to relieve pain, prevent recurrence, and optimise long-term outcomes.

Understanding GTPS and Its Challenges

GTPS is characterised by chronic pain and tenderness over the greater trochanter, the bony prominence on the femur's upper lateral side. This condition often arises from gluteal tendinopathy, bursitis, or a combination of these issues. Left untreated, GTPS can significantly limit everyday activities such as walking, climbing stairs, or even sleeping on the affected side, leading to frustration and reduced quality of life.

Traditional management includes rest, NSAIDs, corticosteroid injections, and physiotherapy. However, many of these approaches provide temporary or incomplete relief. GTPS is frequently a recurring condition that benefits from addressing underlying biomechanical imbalances and innovative therapies like F-ESWT.

The Study: F-ESWT’s Role in GTPS Management

The study led by Ramon et al. provides compelling evidence for using electromagnetic-focused extracorporeal shockwave therapy (F-ESWT) in conjunction with exercise. The research included 103 patients randomly assigned to two groups:

• Treatment Group: Received F-ESWT at an energy flux density of 0.20 mJ/mm².
• Control Group: Received sham therapy at 0.01 mJ/mm².

Both groups followed an identical, structured exercise program designed to improve hip strength and stability. Treatment outcomes were evaluated at baseline, and at 1, 2, 3, and 6 months, using measures such as:

• Visual Analogue Scale (VAS) for pain intensity.
• Harris Hip Score (HHS) and Lower Extremity Functional Scale (LEFS) for functionality.
• EuroQoL-5 Dimensions Questionnaire (EQ-5D) for quality of life.

Key Findings

1. Significant Pain Reduction:
   • The F-ESWT group’s VAS scores dropped from 6.3 to 2.0 within 2 months, compared to a reduction to only 4.7 in the control group (p < 0.001).
   • These substantial improvements persisted across the 6-month follow-up period.
2. Enhanced Functional Outcomes:
   • Secondary outcome measures such as the HHS, LEFS, and EQ-5D showed superior improvements in the F-ESWT group compared to the control group.
   • These benefits were particularly notable in day-to-day mobility and overall quality of life.
3. Safety and Tolerability:
   • No complications were observed during the study, confirming that F-ESWT is a safe and well-tolerated intervention.
4. High Success Rate:
   • The study reported an impressive 86.8% success rate for F-ESWT by the 2-month mark, with improvements maintained throughout the follow-up period.

How F-ESWT Works

F-ESWT involves the application of focused acoustic waves to stimulate healing in damaged tissues. The therapy promotes cellular repair by:

• Increasing Blood Flow: Enhances oxygenation and nutrient delivery to affected areas.
• Stimulating Collagen Production: Supports tendon repair and structural integrity.
• Reducing Inflammation: Lowers levels of inflammatory mediators while encouraging tissue regeneration.

Unlike invasive procedures, F-ESWT is non-invasive and requires minimal downtime, making it an attractive option for patients seeking effective yet convenient treatment.

Applying These Insights at Neurohealth Wellness

At Neurohealth Wellness, we focus on delivering evidence-based care tailored to individual needs. The findings from this study align with our commitment to combining innovative therapies with targeted exercise to achieve long-term recovery.

1. Holistic Approach to Care:
   Beyond symptom relief, we focus on identifying and addressing the root causes of GTPS. A customised exercise program strengthens the hip abductors, stabilises the pelvis, and improves load distribution to prevent future episodes.
2. Multimodal Treatment Strategies:
   Our practitioners integrate advanced modalities like F-ESWT with complementary techniques such as dry needling, acupuncture, and manual therapy. This multimodal approach ensures that treatment is comprehensive and tailored to each patient’s unique needs.
3. Education and Empowerment:
   Patient education is a cornerstone of our practice. By providing guidance on activity modification, ergonomics, and self-care, we empower patients to take an active role in their recovery and maintain their results over the long term.

Conclusion

The findings from this pivotal study underscore the potential of F-ESWT as a game-changing treatment for GTPS. When combined with a targeted exercise program, this approach not only alleviates pain but also enhances functionality and quality of life.

At Neurohealth Wellness, we are dedicated to providing cutting-edge care that prioritises prevention, holistic recovery, and sustainable results. If you or someone you know is experiencing GTPS, our team is here to help. Contact us today at (02) 9905 9099 or visit our website to learn more about our services.

References

1. Ramon, S., et al. (2020). Focused Shockwave Treatment for Greater Trochanteric Pain Syndrome: A Multicenter, Randomized, Controlled Clinical Trial. The Journal of Bone and Joint Surgery, 102(15), 1347-1355. DOI:10.2106/JBJS.20.00093
2. Rompe, J. D., et al. (2009). Effectiveness of Low-Energy Extracorporeal Shockwave Therapy for Chronic Plantar Fasciitis. The American Journal of Sports Medicine, 37(3), 463-470.
3. Speed, C. (2014). A Systematic Review of Shockwave Therapies in Soft Tissue Conditions: Focusing on the Evidence. British Journal of Sports Medicine, 48(21), 1538-1542.
4. Rees, J. D., et al. (2009). Tendon Debridement and Repair: Evidence-Based Approaches and Emerging Techniques. Arthritis Research & Therapy, 11(3), 203.
5. Gollwitzer, H., et al. (2015). Extracorporeal Shockwave Therapy for Chronic Painful Heel Syndrome: A Prospective Randomized Trial. The Journal of Foot and Ankle Surgery, 54(5), 702-710.

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