Steroid shots don't help hip pain long-term

Corticosteroid shots provide quick relief for people suffering from a common type of hip pain, but the benefits don't last, a new study in The American Journal of Sports Medicine shows.

Known as greater trochanter pain syndrome (the trochanter is the upper part of the femur where it joins the pelvis), this condition is typically treated with physical therapy, training error correction, and non-steroidal anti-inflammatory drugs, Dr. Jan D. Rompe of the OrthoTrauma Evaluation Center in Mainz, Germany and his colleagues note.

If these measures don't work-or even if they do-"a local corticosteroid injection is regarded as the standard of care," Rompe and his team say.

But there have been no studies comparing various approaches to treating the hip pain syndrome. To investigate, the researchers randomly assigned 229 people with greater trochanter pain syndrome that hadn't improved with standard treatment to home training, a single corticosteroid injection, or several low-energy shock-wave treatments, in which a machine is used to deliver energy pulses to the painful area.

After a month, 75 percent of the injection group reported significant improvements in pain, compared to 7 percent of those doing the home exercises and 13 percent of those who received the shock-wave therapy. But at four months, 51 percent of those given corticosteroid injections reported sustained improvements in pain, while 68 percent of patients in the shock wave group and 41 percent of the home training group reported significant improvements.

Finally, at 15 months, just 48 percent of patients given steroid shots said their pain was better, compared to 74 percent of the shock wave group and 80 percent of the home training group.

"The role of corticosteroid injection for greater trochanter pain syndrome needs to be reconsidered," Rompe and his colleagues say, adding that patients need to be informed of the "advantages and disadvantages of the treatment options, including the economic burden."

Given that shock wave therapy and home exercise training produced about the same results at 15 months, they add, the choice of which to offer patients could be made based on costs, because home exercise is less expensive.