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Greater Trochanteric Pain Syndrome (GTPS) and Exercise

Three Part Question

In [adults with greater trochanteric pain syndrome or trochanteric bursitis] does [exercise] versus [no treatment or rest] have an effect on pain and/or function?

Clinical Scenario

A 54 year old female presents to the physiotherapy department for treatment of lateral hip pain of insidious onset on going for more than one year. Pain is aggravated by prolonged standing and laying on the affected side. GTPS has been diagnosed on ultrasound. She had a steroid injection which had no long-lasting effect and has now been referred to try exercise rehabilitation in physiotherapy.

Search Strategy

PubMed Clinical queries database was searched using the following terms (see in Search Details section).

In addition the Best BETS, Cochrane Library and PEDrO databases were searched using similar terms. No more articles were found.

1). Greater Trochanteric Pain Syndrome
A/. Clinical Queries
Therapy/Broad[filter] AND (greater[All Fields] AND trochanteric[All Fields] AND ("somatoform disorders"[MeSH Terms] OR ("somatoform"[All Fields] AND "disorders"[All Fields]) OR "somatoform disorders"[All Fields] OR ("pain"[All Fields] AND "syndrome"[All Fields]) OR "pain syndrome"[All Fields]))

B/. Systematic Reviews
systematic[sb] AND (greater[All Fields] AND trochanteric[All Fields] AND ("somatoform disorders"[MeSH Terms] OR ("somatoform"[All Fields] AND "disorders"[All Fields]) OR "somatoform disorders"[All Fields] OR ("pain"[All Fields] AND "syndrome"[All Fields]) OR "pain syndrome"[All Fields]))

2). Greater Trochanteric Pain Syndrome Exercise

A/. Clinical Queries
Therapy/Broad[filter] AND (greater[All Fields] AND trochanteric[All Fields] AND ("somatoform disorders"[MeSH Terms] OR ("somatoform"[All Fields] AND "disorders"[All Fields]) OR "somatoform disorders"[All Fields] OR ("pain"[All Fields] AND "syndrome"[All Fields]) OR "pain syndrome"[All Fields]) AND ("exercise"[MeSH Terms] OR "exercise"[All Fields]))

B/. Systematic Reviews
systematic[sb] AND (greater[All Fields] AND trochanteric[All Fields] AND ("somatoform disorders"[MeSH Terms] OR ("somatoform"[All Fields] AND "disorders"[All Fields]) OR "somatoform disorders"[All Fields] OR ("pain"[All Fields] AND "syndrome"[All Fields]) OR "pain syndrome"[All Fields]) AND ("exercise"[MeSH Terms] OR "exercise"[All Fields]))


3). Trochanteric Bursitis Exercise

A/. Clinical Queries
Therapy/Broad[filter] AND (Trochanteric[All Fields] AND ("bursitis"[MeSH Terms] OR "bursitis"[All Fields]) AND ("exercise"[MeSH Terms] OR "exercise"[All Fields]))


B/. Systematic Reviews
Nil



4). Trochanteric Bursitis

A/. Clinical Queries
Therapy/Broad[filter] AND (Trochanteric[All Fields] AND ("bursitis"[MeSH Terms] OR "bursitis"[All Fields]) AND ("exercise"[MeSH Terms] OR "exercise"[All Fields]))

Two abstracts were deemed possibly relevant and the full articles retrieved.


B/. Systematic Reviews
systematic[sb] AND (Trochanteric[All Fields] AND ("bursitis"[MeSH Terms] OR "bursitis"[All Fields]))

One abstract were deemed possibly relevant and the full articles retrieved.

Search Outcome

3 full papers were retrieved and reviewed no papers matched our PICO question.
Their reference lists were also checked and 4 more articles found whose abstracts were checked; from this one further full article was retrieved which could possibly be relevant to our PICO question.
At the end of the search we had one paper which was retrieved (Rompe 2009). Although this article has exercise within its design so it did not relate directly to our PICO question.

Comment(s)

No papers found to appraise that answered the PICO question.

Clinical Bottom Line

There is currently not enough specific evidence investigating exercise vs rest for GTPS. We will await the outcome of the LEAP trial and review the topic at a later date. In the interim local guidelines will be developed.