This study examined whether local corticosteroid injection, home training, and repetitive low-energy shock wave therapy produce equivalent outcomes 4 months from baseline.Â Two hundred twenty-nine patients with refractory unilateral greater trochanter pain syndrome were assigned sequentially to a home training program, a single local corticosteroid injection or a repetitive low-energy radial shock wave treatment. Subjects underwent outcome assessments at baseline and at 1, 4, and 15 months. Primary outcome measures were degree of recovery, measured on a 6-point Likert scale and severity of pain over the past weekÂ at 4-month follow-up.Â One month from baseline, results after corticosteroid injection were significantly better than those after home training or shock wave therapy. Regarding treatment success at 4 months, radial shock wave therapy led to significantly better results than did home training and corticosteroid injection. The null hypothesis was rejected. Fifteen months from baseline, radial shock wave therapy and home training were significantly more successful than was corticosteroid injection.
The significant short-term superiority of a single corticosteroid injection over home training and shock wave therapy declined after 1 month. Both corticosteroid injection and home training were significantly less successful than was shock wave therapy at 4-month follow-up. Corticosteroid injection was significantly less successful than was home training or shock wave therapy at 15-month follow-up.Â The role of corticosteroid injection for greater trochanter pain syndrome needs to be reconsidered. Subjects should be properly informed about the advantages and disadvantages of the treatment options, including the economic burden.
Rompe, J. D., Segal, N. A., Cacchio, A., Furia, J. P., Morral, A., Maffulli, N. Home Training, Local Corticosteroid Injection, or Radial Shock Wave Therapy for Greater Trochanter Pain Syndrome. The American Journal of Sports Medicine 37:1981-1990