Shock Wave Therapy for Lateral Hip Pain, Caused by Tendon Pathology
Tendinopathy
About this trial
This is an interventional treatment trial for Tendinopathy focused on measuring Shock waves, Greater trochanteric pain syndrome
Eligibility Criteria
Inclusion Criteria:
- duration of lateral hip pain of six weeks or longer,
- normal passive hip range of movement (ROM),
- sonographic evidence of gluteal tendinopathy at their insertional site at the greater trochanter
Exclusion Criteria:
- general contraindication to extracorporeal shock wave therapy (pacemaker, pregnancy, bleeding disorders or anticoagulant drug usage, cancer in the focal area),
- history of rheumatologic disease,
- previous fractures or surgery in the affected limb,
- full thickness tear of the gluteal tendons,
- osteoarthritis of the hip (with ROM limitation),
- clinical signs of lumbar radiculopathy,
- corticosteroid injections or other conservative therapies (except pharmacological pain treatments) since the onset of the current pain episode.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Intervention:f-ESWT (focused shock wave therapy)
Intervention:UST (ultrasound therapy)
In the study-group, a device powered by a piezoelectric generator (PIEZOSON 100PLUS, Richard Wolf) was used . At the beginning of each treatment session, the enthesis of the gluteal tendons at the greater trochanter (at the anterior half of its lateral facet) was targeted through a non-inline sonographic focusing, using a linear probe (7.5-12 MHz) connected to an ultrasound scanner (ESAOTE MYLAB FIVE, Genova and Florence, Italy). All patients received 1800 pulses (frequency=4Hz) of an energy flux density of 0.15 mJ/mm2 once a week for three consecutive weeks. At the first treatment session, the energy flux density was gradually increased from 0.05 to 0.15 mJ/mm2 during the first 500 pulses.
In the control-group, we used a mono-frequency device (ROLAND, RT-20 series, frequency=1MHz). We treated an area of 5cm2, softly moving the US-probe around the most painful point of the greater trochanter at the clinical palpation. UST was supplied in a continuous modality, with an intensity of 1.5 W/cm2, for ten consecutive daily sessions of ten minutes each.