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This study aims to compare the effectiveness of Extracorporeal Shockwave Therapy (ESWT) with conventional physical therapy in patients with Greater Trochanteric Pain Syndrome (GTPS). GTPS is a common cause of lateral hip pain, often related to gluteal tendinopathy rather than trochanteric bursitis. Sixty patients will be randomly assigned to two groups: ESWT or conventional physical therapy (TENS, hot pack, ultrasound). Pain (VAS), hip function (Harris Hip Score), lower limb function (LEFS), and global improvement will be evaluated at baseline, week 3, and week 12. The purpose of this study is to determine which treatment provides greater pain relief and functional improvement.
Greater Trochanteric Pain Syndrome (GTPS) is a frequent cause of lateral hip pain and is now understood to be primarily associated with gluteus medius and minimus tendinopathy rather than inflammation of the trochanteric bursa. Although several conservative treatments are available, including nonsteroidal anti-inflammatory drugs and physical therapy modalities, there is no consensus on the most effective treatment strategy. Extracorporeal Shockwave Therapy (ESWT) has emerged as a potential non-invasive treatment option that may promote tissue regeneration, reduce pain, and improve tendon healing.
This prospective randomized controlled trial will include 60 patients aged 18-65 years with MRI-confirmed GTPS. Participants will be randomly assigned (1:1) to either the ESWT group or the conventional physical therapy group. The ESWT group will receive five sessions over 3 weeks (15 Hz, 3 bar, 2000 pulses). The physical therapy group will receive 10 sessions of TENS (20 minutes), hot pack (20 minutes), and continuous ultrasound (1.5 W/cm², 5 minutes). Both groups will be given a standardized exercise program.
Outcome measures include the Visual Analog Scale (VAS) for pain (night, rest, activity), Harris Hip Score, Lower Extremity Functional Scale (LEFS), and the Global Rating of Change Scale. Assessments will be performed at baseline, week 3, and week 12. The primary objective is to compare the effect of ESWT versus conventional physical therapy on pain reduction. Secondary objectives include evaluating functional improvements and global patient satisfaction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ESWT Group | Experimental | Extracorporeal shockwave therapy applied 5 sessions over 3 weeks (15 Hz, 3 bar, 2000 pulses). Standard hip exercises included. |
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| Conventional Physical Therapy Group | Active Comparator | 10 sessions of TENS (20 min), hot pack (20 min), and continuous ultrasound (1.5 W/cm², 5 min). Standard hip exercises included. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Extracorporeal Shockwave Therapy (ESWT) | Device | ESWT applied with Elmed Vibrolith Ortho device at 15 Hz, 3 bar, 2000 pulses, 5 sessions over 3 weeks. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Visual Analog Scale (VAS) Pain Score | Pain intensity will be assessed using a 0-10 Visual Analog Scale (VAS) for activity, rest, and night pain. The primary endpoint is the change in VAS score from baseline to Week 12. | Baseline, Week 3, and Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Harris Hip Score | Hip function will be evaluated using the Harris Hip Score, which includes pain, daily activities, gait, and range of motion parameters. Higher scores indicate better hip function. | Baseline, Week 3, and Week 12 |
| Lower Extremity Functional Scale (LEFS) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zeynep Karakuzu Güngör, M.D | Contact | +90 507 775 03 75 | zeynepkarakuzu@hotmail.com.tr |
| Name | Affiliation | Role |
|---|---|---|
| Zeynep Karakuzu Güngör | Kanuni Sultan Suleyman Training and Research Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kanuni Sultan Süleyman Training and Research Hospital | Recruiting | Istanbul | 34303 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D000074059 | Extracorporeal Shockwave Therapy |
| D004561 | Transcutaneous Electric Nerve Stimulation |
| D019220 | High-Energy Shock Waves |
| ID | Term |
|---|---|
| D014464 | Ultrasonic Therapy |
| D003972 | Diathermy |
| D006979 | Hyperthermia, Induced |
| D013812 | Therapeutics |
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Two-arm, parallel-group, randomized controlled trial (1:1 allocation).
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| TENS; Hot Pack; Ultrasound | Other | 10 sessions of TENS (20 min), hot pack (20 min), and continuous ultrasound (1.5 W/cm², 5 min). |
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The LEFS questionnaire will be used to assess lower limb function. It consists of 20 items scored from 0 to 4 (total score 0-80), with higher scores indicating better function. |
| Baseline, Week 3, and Week 12 |
| Global Rating of Change (GROC) | Overall patient-perceived improvement will be assessed using the Global Rating of Change Scale, scored from -1 (worse) to +3 (near normal improvement). | Week 3 and Week 12 |
| D026741 |
| Physical Therapy Modalities |
| D012046 | Rehabilitation |
| D004599 | Electric Stimulation Therapy |
| D000698 | Analgesia |
| D000760 | Anesthesia and Analgesia |
| D000069453 | Ultrasonic Waves |
| D013016 | Sound |
| D011840 | Radiation, Nonionizing |
| D011827 | Radiation |
| D055585 | Physical Phenomena |