Extracorporeal Shockwave Therapy (ESWT) For Hip Pain In Adolescents And Young Adults

PURPOSE: Extracorporeal shockwave therapy (ESWT) is emerging as an effective non-invasive treatment modality for musculoskeletal injuries. However, there is a gap in the literature on ESWT treatment in the management of periarticular hip pain in adolescents and young adults. This study aimed to describe the demographic profiles and outcomes in a cohort of adolescents and young adults who were treated with ESWT for hip pain. METHODS: This retrospective cohort study included patients 12-26 years old who underwent at least one session of ESWT for hip flexor or lateral hip pain from January 2022 to September 2023. Patient characteristics of interest included primary diagnosis, primary sport or activity, and type and number of ESWT treatments. Outcome measures were collected prior to each weekly ESWT session, which included the 10-point Visual Analog Scale (VAS) and hip disability and osteoarthritis outcome score (HOOS). HOOS ranges from 0 (worse hip symptoms) to 100 (no symptoms). Short-term outcomes were assessed comparing scores reported before the first session (initial) to the last submitted scores. RESULTS: 28 participants were included in the analyses (24 Females, 4 Males; Age: 19.71 ± 3.42 years). The most common diagnoses were psoas and/or rectus tendinopathy (50%) and lateral hip pain from gluteal and/or TFL tendinopathy (32%), with mixed causes observed in the remaining cases. Radial ESWT was the preferred treatment for 68% of participants, with an average of 4.7 sessions administered per participant. Primary sports or activities included dancing (32%) and soccer, hockey, and swimming (7.1% each). The average duration between reported outcomes was 64.25 days. Initial v. last treatment outcomes of HOOS and VAS were 60.62 v. 66.21, p = 0.014 and 5.89 v. 4.61, p = 0.002, respectively. CONCLUSIONS: The most common sport/activity in our study cohort receiving ESWT was dance. ESWT was most commonly used to treat hip flexor tendinopathy. ESWT for the use of hip flexor and lateral hip pain in adolescent and young adult athletes was correlated with short term improvement in function and pain. Further analysis will elucidate longer term efficacy and potential predictors of treatment response.