Treatment of Trochanteric Pain Syndrome

Introduction to Guideline Recommendations

The American College of Sports Medicine recommends a progressive resistance exercise program for at least 3 months, with a minimum of 12 supervised sessions, as the first-line treatment for trochanteric pain syndrome 1, 2
The British Journal of Sports Medicine suggests that exercises focusing on hip and pelvis motor control, particularly in single-leg support positions, should be included in the rehabilitation program 1, 2

Progressive strengthening exercises of the hip muscles, with an emphasis on the gluteus medius muscle, constitute the basis of the rehabilitation program, as recommended by the American College of Sports Medicine 1, 2, 3
The program should specify the magnitude of load, number of repetitions and sets, duration of the contractile component of the exercise, time under tension, rest between repetitions and sessions, and range of motion through which the exercise is performed, according to the British Journal of Sports Medicine 1, 2, 5

The American College of Sports Medicine recommends privileging active physiotherapeutic interventions (supervised exercise) over passive interventions (massage, ultrasound, heat) 6
Local corticosteroid injections in the region of the greater trochanter can be considered for patients with stable pain despite NSAIDs, with symptom resolution rates ranging from 49% to 100%, as reported in Arthritis care & research 6

The British Journal of Sports Medicine suggests discussing patient expectations regarding treatment outcomes, including the risks of surgical and non-surgical options, the likely extent of improvement, and the anticipated duration, as part of a shared decision-making process 7, 5
Explaining the relationship between pain and joint structure, including the prevalence of morphological findings in asymptomatic individuals, is recommended by the American College of Sports Medicine 5

The American College of Sports Medicine recommends that complete rest or prolonged inactivity is not advised, as it can lead to muscle weakness, joint stiffness, and potentially worsen functional outcomes over time 3
Strategic periods of rest should be incorporated between exercise sessions to allow for recovery, as suggested by the British Journal of Sports Medicine 3

The American College of Sports Medicine advises against interrupting the exercise program before 3 months, as shorter programs lead to suboptimal results 3, 4
Pushing through severe pain during exercise can exacerbate inflammation and damage, as reported in Praxis Medical Insights: Practical Summaries of Clinical Guidelines 3