Conservative treatments for greater trochanteric pain syndrome: a systematic review.

Greater trochanteric pain syndrome (GTPS) can have a significant effect on quality of life. The aim of this study was to evaluate the conservative treatments for GTPS through the use of a systematic review.

8 studies (n=696) were eligible for inclusion in the review; corticosteroid injections (CSI) (n=6), shockwave therapy (n=2), home training (n=1) and orthotics (n=1). Based on pain, CSI demonstrated superior outcomes for up to 3 months compared with home training, radial shockwave therapy (RSWT) and usual care, in 4 studies demonstrating either a low or moderate risk of bias. Fluoroscopy-guided injections failed to show additional benefit. RSWT and home training had limited evidence. No conclusions can be drawn regarding the use of orthotics due to the serious risk of bias and methodological flaws within that study.

This review demonstrates a paucity of high-quality research for the conservative treatments of GTPS. The risk of bias was low in only one study, demonstrating no additional benefit with fluoroscopically guided injections. Risk of bias in all remaining studies was varied. Standardisation of diagnostic criteria and outcome measures is essential to enable more powerful analysis.