Treatment
Explain the patient that the condition is usually self limiting and tends to respond to conservative therapy such as:
- rest
- nonsteroidal anti inflammatory drugs
- application of ice and heat to the affected area
- stretching and strengthening
- weight loss if appropriate
- physical therapy
- behavior modification - aimed at improving flexibility, muscle strength and joint mechanics while decreasing pain
- low energy shock wave therapy (SWT)
Patients who continue to have pain despite the initial conservative methods should be treated with local anaesthetic and corticosteroid injections to provide intermediate-term relief (1)
- the response rate ranges from 60-100%
- inject the point of maximal tenderness (1)
Surgical interventions are reserved for patients with refractory disease, non-respondent to conservative treatments. Surgery usually incorporates a combination of interventions which include:
- bursectomy
- iliotibial band (ITB) release
- trochanteric reduction osteotomy
- gluteal tendon repair (2)
Reference:
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