Effect of extracorporeal shockwave therapy on pain reduction and improved functional outcomes for greater trochanteric tendinopathy: A critically appraised topic

Introduction/Objectives: Chronic greater trochanteric tendinopathy (GTT) is a significant musculoskeletal condition, particularly affecting athletes involved in long-distance or repetitive highimpact activities. Characterized by lateral hip pain and functional impairments, it poses substantial challenges to athletic performance and recovery. Traditional interventions, including strengthening, stretching, and load management, often result in suboptimal success. This Critically Appraised Topic (CAT) examines the efficacy of extracorporeal shockwave therapy (ESWT) in reducing pain and improving functional outcomes in athletes with chronic GTT.

Methods: A systematic search of PubMed, EBSCOhost, CINAHL, and SPORTDiscus was conducted. Studies meeting inclusion criteria focused on athletes with GTT, utilized ESWT as an intervention, and reported pain reduction and functional improvement outcomes. Four high-quality studies, including three randomized controlled trials (RCTs) and one retrospective cohort study, were identified and analyzed. Evidence levels were assessed using the Oxford Center for Evidence-Based Medicine (OCEBM) and the Physiotherapy Evidence Database (PEDro) scale.

Results: ESWT significantly reduced pain and improved function in GTT patients, particularly when paired with therapeutic exercise. Level 2 evidence from randomized controlled trials highlighted longterm benefits, while retrospective cohort data supported its sustained efficacy. Specific improvements included reductions in visual analog scale (VAS) pain scores and enhanced lower extremity functional scale (LEFS) outcomes.

Conclusions: ESWT is a promising, non-invasive intervention for managing GTT. It offers significant pain relief and functional improvements, enhancing athlete care and recovery. Further research is recommended to standardize treatment protocols, validate biomarkers for tendon healing, and optimize clinical applications.