Shockwave Therapy for Greater Trochanteric Pain Syndrome (GTPS)

Understanding Greater Trochanteric Pain Syndrome (GTPS)

What is GTPS?

Greater trochanteric pain syndrome (GTPS) is a condition characterised by pain and tenderness over the greater trochanter, the bony prominence on the outer side of the hip. GTPS is often associated with inflammation or degeneration of the tendons and bursae surrounding the greater trochanter. This condition is more common in women and middle-aged individuals.

Causes and Risk Factors

GTPS can be caused by various factors, including:

• Overuse or repetitive strain on the hip muscles and tendons
• Weakness or tightness in the hip abductor muscles
• Biomechanical issues, such as leg length discrepancy or poor running form
• Direct trauma to the hip or greater trochanter
• Spinal conditions or lower back pain that alter hip mechanics
• Degenerative changes in the hip joint or spine

Shockwave Therapy for GTPS

What is Shockwave Therapy?

Shockwave therapy, also known as extracorporeal shockwave therapy (ESWT), is a non-invasive treatment that uses high-energy sound waves to stimulate healing in damaged tissues. The shockwaves are delivered through a handheld device applied to the skin over the affected area, targeting the greater trochanter and surrounding tissues in the case of GTPS.

How Shockwave Therapy Works

While the exact mechanisms of shockwave therapy are not fully understood, it is believed to promote healing through several pathways:

• Increasing blood flow and metabolism in the treated area to promote tissue repair
• Breaking up calcifications or scar tissue that may be contributing to pain and inflammation
• Stimulating the release of growth factors and other biochemicals that promote healing
• Reducing pain by modulating nerve impulses and decreasing sensitivity

The Shockwave Therapy Procedure for GTPS

Shockwave therapy for GTPS is an outpatient procedure that typically takes 15-30 minutes per session. The process involves the following steps:

1. The patient lies on their side with the affected hip exposed
2. A gel is applied to the skin over the greater trochanter to facilitate shockwave transmission
3. The physiotherapist positions the handheld device on the skin and delivers the shockwaves to the affected area
4. Some discomfort or pain may be experienced during the procedure, but this is generally well-tolerated
5. After the session, the patient can usually return to normal activities, although temporary soreness or swelling may occur

Treatment Protocol and Expected Outcomes

The number of shockwave therapy sessions needed for GTPS varies depending on the severity of the condition and individual response to treatment. A typical treatment protocol may include:

• 3-5 sessions, scheduled 1-2 weeks apart
• Progressive improvement in symptoms over the course of treatment
• Continuation of a stretching and strengthening programme to prevent recurrence

Studies have demonstrated that shockwave therapy can be an effective treatment option for GTPS, with many patients experiencing significant reductions in pain and improved function following treatment.

Complementary Treatments and Prevention Strategies

Combining Shockwave Therapy with Other Modalities

Shockwave therapy can be a powerful tool in managing GTPS, but it is often most effective when combined with other treatment modalities, such as:

• Physical therapy to address muscle imbalances, improve flexibility, and correct biomechanical issues
• Nonsteroidal anti-inflammatory drugs (NSAIDs) or ice therapy to manage pain and inflammation
• Gradual return to activity, with modifications as needed to prevent further injury
• Corticosteroid injections, in some cases, to reduce inflammation and pain

Preventing GTPS

To reduce the risk of developing GTPS, consider the following prevention strategies:

• Maintain flexibility and strength in the hip and core muscles through regular stretching and exercise
• Gradually increase training intensity and duration, allowing the body time to adapt
• Use proper form and technique during activities that put stress on the hips, such as running or cycling
• Wear appropriate footwear that provides adequate support and cushioning for your specific activity
• Address any underlying biomechanical issues or muscle imbalances that may contribute to hip stress

At MSKClinic, we offer shockwave therapy as part of our comprehensive approach to treating GTPS and other musculoskeletal conditions. Our skilled physiotherapists work closely with each patient to develop a personalised treatment plan incorporating the latest evidence-based techniques and a strong focus on patient education and empowerment. If you are experiencing symptoms of GTPS, contact us today to learn more about how shockwave therapy and our other services can help you find relief and get back to the activities you love.