Greater trochanteric pain syndrome in the UK National Health Service: a multicentre service evaluation

Purpose
Greater trochanteric pain syndrome (GTPS) is a debilitating condition causing lateral hip pain. A recent randomized controlled trial (LEAP) demonstrated that exercise interventions for GTPS provided superior outcomes, compared with corticosteroid injection and wait-and-see approaches. However, participants were not patients seeking care and therefore may not have represented the typical patient seen within the National Health Service (NHS). The present service evaluation aimed to provide data on the characteristics of patients with GTPS presenting to NHS physiotherapy services, to enable consideration of the applicability of the findings of the LEAP trial to patients seeking care within the NHS.

Methods
Four NHS sites provided anonymized data on patients presenting to their service with a primary complaint of GTPS.

Results
The data from 162 patients suggested that the typical patients presenting to the NHS with GTPS are female (73%), overweight (body mass index 28.5) and experiencing a 12-month or longer history of lateral hip pain (56.8%). Patients reported high levels of pain (visual analogue score 6.5), low health-related quality of life (EuroQol five-dimensions – 5-level score 0.6), coexisting medical conditions (79.0%) and high medication use (82.7%).

Conclusions
Patients presenting to the NHS with GTPS appear to have multifactorial issues, with high levels of pain and disability, and are often medicated for multiple coexisting conditions. These characteristics differentiate them from patients recruited to the LEAP trial. Hence, it is unclear whether the findings of the LEAP trial are applicable to patients with GTPS who consult physiotherapy services in the NHS. Further research is warranted to evaluate this.