Dry needling: A promising treatment modality for greater trochanteric pain syndrome

Abstract

Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain, seen more commonly in females between the ages of 40 and 60 years. GTPS is presently attributed to tendinopathy of the gluteus medius and/or minimus with or without coexisting trochanteric bursitis. Conventionally, cortisone injection into the lateral hip, with the intention of injecting the bursa, was accepted treatment for this condition in cases not responding to conservative treatment. But since the etiology of GTPS is not necessarily the bursa, injecting it with steroid is not as logical. As trigger points and myofascial pain of the affected hip and thigh musculature are being implicated as sources of pain, dry needling (DN), that has shown potential in treating a variety of soft-tissue injury and neuromyofascial pain, and which requires the insertion of thin monofilament needles into sensitive loci (trigger points) in the muscles and soft tissue could be an effective option. Hereby, we present a case of a 52-year-old woman, who came to us with chronic lateral lower limb pain since 1 year. The pain was dull aching in quality, extended from the right buttock region to the lateral aspect of thigh and was specially felt on abduction of thigh while sitting in cross-legged position on the ground. The patient had tenderness along proximal lateral thigh around the greater trochanteric region. One-week course of nonsteroidal anti-inflammatory drugs had minimal effect. We decided to treat her with DN in her pain area. The patient reported more than 75% pain relief after the session.