Extracorporeal Shockwave Therapy in Greater Trochanteric Pain Syndrome: A Systematic Review and Meta-Analysis

Background. Greater Trochanteric Pain Syndrome (GTPS) poses significant challenges in clinical management due to its multifactorial etiology and limited treatment options. Extracorporeal Shockwave Therapy (ESWT) has emerged as a promising intervention in the recent past. This review aimed to evaluate the clinical efficacy of ESWT in managing GTPS symptoms. Methods. Systematic searches were conducted on PubMed, Scopus, PEDro, and Web of Science. For quality assessment we utilized the PEDro scale, while Cochrane Risk-of-bias tool version 2 (RoB 2) helped evaluate the risk of bias. Meta-analysis was performed on six out of seven included studies. The primary outcome studied was pain intensity, and secondary outcome was lower extremity function. The analysis was done for r-ESWT and f-ESWT separately, wherever applicable. Results. Seven trials with 714 participants were analyzed; six included in the meta-analysis. The meta-analysis of trials where f-ESWT was given showed that f-ESWT was significantly more effective than control/alternative treatments (SMD = -1.96; 95%CI-3.22 to-0.71; Z = 3.06, p = 0.002) in reducing pain, with significant results obtained in the medium, but not in the long term. f-ESWT was found to be more effective in improving lower extremity function in GTPS (SMD = 0.61; 95%CI 0.41 to 0.81; Z = 6.02 p < 0.00001). r-ESWT did not offer any significant benefit for reducing pain intensity over control/alternative treatments in either short, medium, or long-term follow-ups (SMD =-0.03; 95%CI-0.41 to 0.35; Z = 0.16, p = 0.87). Conclusions. f-ESWT can improve pain intensity and lower extremity function more significantly when compared to control/alternative treatment groups. Study registration. The procedure used for analysis and the pre-determined eligibility criteria was registered at the International Prospective Register of Systematic Reviews (PROSPERO) on March 04, 2024, registration ID: CRD42024515778.