Clinical Predictors of Extracorporal Shockwave Therapy Efficacy in Patients Presenting With Lateral Hip Pain

Clinical Predictors of Extracorporal Shockwave Therapy Efficacy in Patients Presenting With Lateral Hip Pain

This pragmatic clinical trial is considering the variable response to treatment outcome of individuals with Greater Trochanteric Pain Syndrome (GTPS). The aim of this study is to identify predictors of focused extracorporeal shockwave therapy (fESWT) efficacy in individuals with GTPS. Specifically, the ability of clinically applicable measurements including: Patient demographics, co-morbidity, oestrogen levels, pain characteristics, hip abductor strength, time to pain during single-leg stance test, low back pain, and immediate pain reduction to local anaesthetic injection at the trochanter major insertion of Gluteus medius (GMed) during walking.

Inclusion Criteria:

• Lateral hip pain, worst over the greater trochanter, present for a minimum of 3 months
• Age 35-70 years
• Female
• Pain at an average intensity of ≥3 out of 10 on most days of the last week.
• Tenderness on palpation of the greater trochanter
• Pain on one of the following:

Reproduction of pain on 30 sec single leg stand OR Positive Faber test

Exclusion Criteria:

• Any known advanced hip joint pathology where groin pain is the primary complaint and/or reproduction of groin pain with Faber or FADDIR.
• Where range of pure hip joint flexion is <90°
• Radiating pain distal to the Gluteus Max + positive Straight Leg Raise (SLR-test < 30°)
• Known advanced knee pathology or restricted range of knee motion (must have minimum 90° flexion and full extension)
• Any systemic diseases affecting the muscular or nervous system, and uncontrolled diabetes
• Malignant tumour OR Systemic inflammatory disease
• Any factors that would preclude the participant from having an MRI (e.g. pacemaker, metal implants, pregnancy, claustrophobia)
• If the participant is involved in a legal/workcover or other injury claim
• Fear of needles (trypanophobia)
• If the participant is unable to write, read or comprehend Danish