Effectiveness of Combined Dry Needling and Progressive Loading for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial

Background: Greater Trochanteric Pain Syndrome (GTPS) is a prevalent condition affecting about 10-25% of the general population, presenting as chronic lateral hip pain, which can impair function and quality of life. There are many potential interventions for GTPS, but there is little evidence for the effectiveness of dry needling with progressive loading exercise. This study aimed to determine the effect of dry needling with progressive loading exercise compared to standard care for patients with GTPS. Methods: In this assessor-blinded randomized controlled trial, conducted in Islamabad, Pakistan, 124 adults (30-65y) were recruited with a diagnosis of GTPS and were randomized to either receive dry needling with progressive loading exercise (intervention group, n=62) or standard care (control group, n=62), with 12 sessions over 6 weeks. The primary outcome was pain intensity measured with the Numerical Pain Rating Scale (NPRS), while the secondary outcomes were Hip Disability and Osteoarthritis Outcome Score (HOOS), pressure pain threshold (PPT), and Global Rating of Change (GROC). Assessments were conducted at baseline, 6 weeks, and 12 weeks. Results: At 12-week follow-up, the intervention group showed a significantly greater reduction in pain intensity compared to the control group (between-group mean difference: -2.3 points, 95%CI [-2.8,-1.8], p<0.001). Greater improvements were also observed for all other HOOS subscales, augmented for Sport/Recreation Function (19.9 points) and Quality of Life (20.4 points). The intervention group self-reported larger success rates (GROC ≥+4) than the control group at 12-week follow-up (81.4% versus 43.1%, p<0.001). Conclusion: Combined dry needling and progressive loading exercises are superior to the standard of care for reducing pain and improving function in individuals with GTPS, sustained at a 12-week follow-up. DOI: https://doi.org/10.59564/amrj/03.02/005