Michael Denman, MD
Do corticosteroid injections improve recovery and reduce pain in the greater trochanteric pain syndrome (GTPS)?
Randomized controlled trial. Current Controlled Trials ISRCTN 16994576.
Unclear allocation concealment.*
3 and 12 months.
Primary care practices of 81 physicians in the Rotterdam area of the Netherlands.
120 patients 18 to 80 years of age (mean age 56 y, 77% women) with GTPS (> 1 wk duration of pain in the lateral region of the hip and reproduction of patient pain on palpation of the greater trochanter). Exclusion criteria included systemic neurologic or rheumatologic disorders, previous surgery in the same region, or consultation with the primary care physician for the same symptoms within the past year resulting in any intervention.
Local corticosteroid injection of triamcinolone acetate, 40 mg, plus lidocaine, 1% or 2%, given in the painful area in 1-mL measures from a 5-mL syringe until the syringe was empty (n = 60), or usual care (n = 60). Physicians could give a second injection at 3 weeks to 3 months.
Recovery, defined as score 1 (totally recovered) or 2 (strongly improved) on a 7-point Likert scale; pain severity at rest and with activity during the past week (score 0 to 10, 10 = worst conceivable pain); and adverse events.
99% at 3 months and 93% at 12 months (intention-to-treat analysis).
The main results are in the Table. 38% of patients in the group receiving injections had superficial pain at the injection site on day 1; groups did not differ for other adverse events at 6 weeks.
Local corticosteroid injections improved recovery and reduced pain at 3 months but not 12 months in patients with the greater trochanteric pain syndrome.
†Abbreviations defined in Glossary. RBI, NNT, and CI calculated from data in article.
‡Score 1 or 2 (totally recovered or strongly improved) on 7-point Likert scale.
§Score range 0 to 10, 10 = worst conceivable pain.
||Adjusted for baseline scores.
Denman M. Corticosteroid injections improved short-term but not long-term recovery and pain in the greater trochanteric pain syndrome. Ann Intern Med. ;155:JC4–9. doi: 10.7326/0003-4819-155-8-201110180-02009
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Published: Ann Intern Med. 2011;155(8):JC4-9.
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