Effectiveness of Extracorporeal Shock Wave Therapy in the Management of Greater Trochanteric Pain Syndrome: A Systematic Review

Greater trochanteric pain syndrome (GTPS) is a common musculoskeletal condition that predominantly affects middle-aged women. Although conservative interventions such as corticosteroid injections and physiotherapy are widely used, their long-term efficacy remains controversial. Extracorporeal shock wave therapy (ESWT) has emerged as a promising non-invasive treatment modality. This systematic review evaluated the effectiveness of ESWT in the management of GTPS, focusing on pain reduction, functional improvement, and quality-of-life outcomes. A comprehensive literature search was conducted in PubMed, MEDLINE, Embase, Cochrane Library, Ovid, and CINAHL Plus for relevant studies published up to February 2025, following PRISMA 2020 guidelines. Randomized controlled trials (RCTs) comparing ESWT with other conservative treatments or placebo were included. Data were extracted regarding patient population, intervention protocols, outcome measures, and follow-up durations. Six RCTs involving a total of 659 patients with chronic GTPS were analyzed. Overall, ESWT was associated with reductions in pain intensity and improvements in lower-limb function and health-related quality of life across the included studies. Compared to corticosteroid injections, ESWT appeared to provide more durable benefits at medium- and long-term follow-up in several studies. Its efficacy was comparable to, and in some cases greater than, physiotherapy-based interventions. However, heterogeneity in treatment protocols and outcome reporting limits generalizability. ESWT appears to be a promising and safe non-invasive option for managing GTPS, with several studies reporting sustained pain relief and functional benefits at follow-up periods extending up to 12-15 months. Further high-quality RCTs with standardized protocols are needed to confirm these findings and guide clinical practice.