Comparative study between ultrasound-guided local injection of corticosteroid and shockwave in treatment of greater trochanteric pain

Abstract

Background: Greater trochanteric pain syndrome (GTPS) is a medical disorder marked by pain and tenderness in the immediate area of the trochanteric region.Objectives: Comparing the effect of ultrasound guided injection of corticosteroid and extracorporeal shock wave therapy for refractory GTPS.Methods: This prospective randomized study was conducted on 30 adult patients of both sexes, diagnosed with chronic GTPS. Patients were subdivided into two equal groups: Group I: Treated by twice injections of 1 ml methyl prednisolone combined with 4ml of lidocaine 2 weeks apart under ultrasound guidance. Group II: Treated by extracorporeal shock wave therapy. 4 sessions one week apart of radial shock wave, 2000 pulses, energy level (2.0-3.0 bar), frequency 12Hz.Results: There was a notable disparity in pain relief, as measured by the Visual Analogue Scale (VAS) and the Lower Extremity Functional Scale (LEFS), between the two groups after 4 weeks and 3 months. Only the Numerical Rating Scale (NRS) and Roles and Maudsley Score (RMS) shown results at the 3-month mark. The evaluation of pain using VAS, NRS, and LEFS revealed a significant disparity in group 1 and 2 at three different time points: before and after 4 weeks, before and after 3 months, and between 4 weeks and 3 months. The root mean square (RMS) analysis revealed a notable disparity in group 1 when comparing the periods of (Pre and 4 weeks), (Pre and 3 months), and (4 weeks and 3 months). Similarly, in group 2, there was a substantial difference seen between the periods of (Pre and 4 weeks) and (Pre and 3 months).Conclusions: In the treatment of GTPS, corticosteroid and extracorporeal shock wave therapy effectively alleviate pain and improve function. These methods are particularly useful when conventional physical therapy has failed.