Modalities and Devices

Ice/heat as well as ultrasound is commonly used for this condition.71 Low-energy shock-wave therapy has also been studied and has proven to show some benefit, however, improvements are often temporary and studies have significant limitations in the literature.69

Supplements and Medications

Anti-inflammatory medications may be very beneficial in patients diagnosed with greater trochanteric pain syndrome.71

Complementary and Alternative Medicine

Some patients find acupuncture, chiropractic treatment, and massage beneficial for their pain.

Psychology

One may choose to refer their patients with refractory pain to pain psychology.

Cortisone Injections

Usually, one corticosteroid injection provides a significant improvement in pain and function.69 Injections typically provide short-term relief (3 months); however, it appears that they do not affect long-term resolution of pain at 1 year.73

Surgical Intervention

Surgery is indicated for severe refractory cases. Surgical management may involve lengthening/ release of the ITB and fascia lata (proximal Z-plasty, proximal longitudinal release, and distal Z-plasty). For others, treatment may involve a bursectomy or trochanteric reduction osteotomy. Repairing tears of gluteus medius and gluteus minimus have been shown to improve pain.69

Upcoming Research

The newest advances in treatments include the following: biologic treatments including PRP, the use of ultrasound guided injection techniques, and new arthroscopic approaches. Further research is needed in these areas.7174

 
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