Is shockwave therapy effective in the management of greater trochanteric pain syndrome? A systematic review and meta-analysis.

Harding, Dan; Cameron, Lee; Monga, Aastha; Winter, Sara

Abstract

Evidence is lacking for the efficacy of shockwave therapy (SWT) in the treatment of greater trochanteric pain syndrome (GTPS). To investigate the efficacy of SWT on pain and function in the management of GTPS. A systematic search of electronic databases and grey literature was conducted up to May 2023. Studies utilising SWT on adults for GTPS, providing measures of pain and/or function at baseline and at follow-up were considered for inclusion. Meta-analysis was undertaken using converted pain and functional outcomes. Studies were assessed for quality and risk of bias, and assigned a level of evidence as per the Grading of Recommendations, Assessment, Development and Evaluations criteria. Twelve articles (n = 1121 subjects) were included, including five randomised controlled trials (RCTs) and seven non-RCTs. No statistical differences were observed for pain over time f(1,5) = 1.349 (p = 0.298) or between SWT and control f(1,5) = 1.782 (p = 0.238). No significant differences in functional outcomes in short- (H = 2.591, p = 0.181) and medium-term follow-up (H = 0.189, p = 0.664) were identified between SWT and control. Moderate magnitude treatment effects for pain (Hedges-G [HG] 0.71) favouring SWT groups over control was identified, decreasing to low for function (HG 0.20). Further pain and functional treatment effects were identified at higher magnitudes across follow-up time-points in SWT groups compared to control. Moderate-quality evidence demonstrated no statistically significant improvements in pain and function post-SWT compared to control. Low-quality evidence established clinical improvements throughout all included studies favouring SWT over control. Consequently, owing to relatively low incidence of side effects, SWT should be considered a viable option for the management of GTPS. Issues with both clinical and statistical heterogeneity of studies and during meta-analysis require consideration, and more robust RCTs are recommended if the efficacy of SWT for the management of GTPS is to be comprehensively determined. [Abstract copyright: © 2024 John Wiley & Sons Ltd.]

Citation

Harding, D., Cameron, L., Monga, A., & Winter, S. (2024). Is shockwave therapy effective in the management of greater trochanteric pain syndrome? A systematic review and meta-analysis. Musculoskeletal Care, 22(2), Article e1892. https://doi.org/10.1002/msc.1892

• Journal Article Type: Review
• Acceptance Date: Apr 23, 2024
• Online Publication Date: May 22, 2024
• Publication Date: 2024-06
• Deposit Date: Aug 23, 2024
• Journal: Musculoskeletal care
• Print ISSN: 1478-2189
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 2
• Article Number: e1892
• DOI: https://doi.org/10.1002/msc.1892
• Keywords: greater trochanteric pain syndrome, Pain Management - methods, Femur, function, trochanteric bursitis, Extracorporeal Shockwave Therapy, pain, shockwave therapy, glutaeal tendinopathy, Treatment Outcome, Humans
• Public URL: https://keele-repository.worktribe.com/output/847395
• Publisher URL: https://onlinelibrary.wiley.com/doi/10.1002/msc.1892