Non-surgical treatment as the first step to manage peritrochanteric space disorders

Abstract

Purpose: Greater trochanter pain syndrome (GTPS) or lateral hip pain terms include external snapping hip, trochanteric bursitis and gluteus medius or minimus pathology. The aim of this review is to update the most recent knowledge about non-surgical management of peritrochanteric disorders.

Methods: A literature review was performed including articles most relevant in the last years that were focused in non-surgical treatment of peritrochanteric disorders.

Results: Conservative treatment still has a place and includes activity modification, NSAIDs, analgesics, physiotherapy, home training, local corticosteroid injection (CSI) and shock wave therapy (SWT). These non-surgical alternatives have demonstrated good clinical results with low rate of complications.

Conclusion: Most patients tend to resolve GTPS or lateral hip pain with non-surgical management in the mid-term but when everything failed, surgical options should be evaluated. The next frontier that will be a game changer is to determine an individualized treatment plan based on the exact pathology.

Level of evidence: V.

Keywords: Bursitis; Conservative treatment; Corticosteroid injection; Extracorporeal shock wave therapy; Greater trochanter pain syndrome; Physical therapy; Trochanter.