Dry Needling as an Alternative Treatment for Greater Trochanter Pain Syndrome
Understanding Greater Trochanter Pain Syndrome
Greater trochanter pain syndrome (GTPS), also known as greater trochanteric or subgluteal bursitis, refers to injuries affecting the outer hip. The primary symptoms of GTPS include chronic and intermittent pain in the outer thigh and hip region. This condition typically arises from inflammation or injury to the tissues surrounding the greater trochanter, which includes muscles, tendons, fascia, and bursae.
A bursa is a fluid-filled sac that facilitates smooth movement between uneven surfaces. Research indicates that most GTPS cases stem from minor tears or damage to adjacent muscles or tendons, with inflamed bursae being a less common cause. While this type of hip pain can occur in younger individuals engaged in increased physical activity, it predominantly affects women aged 40 to 60, as well as patients with concurrent low back pain, osteoarthritis, and obesity.
Historical Treatment Approaches
Initial studies pointed to a swollen hip bursa as the primary source of pain, leading to the application of corticosteroid injections aimed at reducing swelling and alleviating discomfort. However, recent findings suggest that the actual source of pain arises from injuries to the surrounding muscles and tendons rather than inflammation.
Research on Dry Needling
An article authored by Brennan and colleagues in the Journal of Orthopedic and Sports Physical Therapy (2017) explored the efficacy of dry needling as an alternative to cortisone injections for alleviating pain and enhancing function in patients with lateral hip pain. The study involved 43 participants (50 hips) diagnosed with GTPS, who were randomly assigned to receive either cortisone injections or dry needling.
The results indicated comparable outcomes between the two groups, with both dry needling and steroid injections leading to reduced pain and improved mobility for daily activities during both short- and long-term follow-ups. Given the potential adverse effects associated with corticosteroid injections, particularly with repeated use, the researchers advocate for dry needling combined with physical therapy as a viable treatment option for GTPS.
Conclusions and Future Research
The researchers concluded that dry needling is non-inferior to cortisone injections for treating GTPS. However, they noted the need for further studies to fully assess the effectiveness of dry needling. Limitations of the study included the absence of a control group, a relatively small sample size, and a brief study duration.
Written By: Nupur Srivastava, PhD