Näytönastekatsaukset

Effectiveness of Glucocorticoid injection for Greater Trochanteric Pain Syndrome

Näytönastekatsaukset

3.3.2026

Eveliina Heikkala and Kalle Saikkonen

Level of evidence: D

On medium term and long term, the impact remained uncertain.

The quality of the evidence is downgraded due to risk of bias, inconsistency and imprecision.

Table 1. Description of the included studies
Reference	Study type	Population	Intervention and comparison	Outcomes	Risk of bias
RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis
«Wang Y, Wang K, Qin Y, et al. The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials. J Orth»1	SR/MA of RCTs	Adult patients with GTPS.	Glucocorticoid + local anesthetic injection vs. wait and see and usual care or placebo	Short-, medium-, long-term, and extra long-term pain intensity	Moderate
«Nissen MJ, Brulhart L, Faundez A, et al. Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clin Rheumatol 2019;38(3):647-6»2	RCT	Adult patients with GTPS.	Ultrasound-guided glucocorticoid + local anesthetic injection vs. placebo	Short-term pain intensity	Low

Table 2. Additional comments for included studies
Reference	Comments
«Wang Y, Wang K, Qin Y, et al. The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials. J Orth»1	Wide inclusion criteria without definition of the outcome measures for the literature search. Patients with ongoing treatments were not excluded even though studies included had excluded those patients. Diagnostic criteria for GTPS were not clearly defined thus varied. Highly limited number of studies involved. Bias of included studies: Allocation concealment and blinding of outcome assessment was not described/mentioned in one study. Blinding was not performed in both.
«Nissen MJ, Brulhart L, Faundez A, et al. Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clin Rheumatol 2019;38(3):647-6»2	Double-blinded study with a successful randomization. All patients participated in the follow-up. No selective outcome reporting or incomplete data. Blinding of outcome assessment was not mentioned. Pain intensity was assessed 30 min after the injection that may have influenced the blinding. Concurrent treatments were requested to be avoided, but usage of pain medication was not screened. Target number of patients was not exceeded.

Results

Table 3. Short-term pain intensity in NRS scale of 0-10 (1 to 6 weeks)
Reference	Number of studies and number of patients (I/C)	Follow-up time	Mean (sd) I	Mean (sd) (%) C	Std. Mean difference (95% CI)
Level of evidence: very low The quality of evidence is downgraded due to study limitations, inconsistency, indirectness, imprecision. I=intervention; C=comparison; CI=confidence interval
«Wang Y, Wang K, Qin Y, et al. The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials. J Orth»1	3 studies, 300 patients (147/153)	4-6 weeks	NA	NA	-0.45 (-1.06 to 0.17)
«Nissen MJ, Brulhart L, Faundez A, et al. Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clin Rheumatol 2019;38(3):647-6»2	One, 46 patients (21/25)	4 weeks	NA	NA	Not reported. Reduction of NRS: Intervention group: -1.5 Control group: -2.5 (p=0.23)

Table 4. Medium-term pain intensity in NRS scale of 0-10 (6 to ≤ 12 weeks)
Reference	Number of studies and number of patients (I/C)	Follow-up time	Mean (sd)) I	Mean (sd) C	Std. Mean difference (95% CI)
Level of evidence: low The quality of evidence is downgraded due to study limitations. One small trial using placebo as control did not measure medium or long-term follow ups. I=intervention; C=comparison; CI=confidence interval
«Wang Y, Wang K, Qin Y, et al. The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials. J Orth»1	2 studies, 254 (126/128)	8 weeks to 3 months	NA	NA	-0.47 (-0.72, -0.22)

Table 5. Long-term pain intensity in NRS scale of 0-10 (3-6 months)
Reference	Number of studies and number of patients (I/C)	Follow-up time	Mean (sd) I	Mean (sd) C	Std. Mean difference (95% CI)
Level of evidence: low The quality of evidence is downgraded due to study limitations and imprecision. One small trial using placebo as control did not measure medium or long-term follow ups. I=intervention; C=comparison; CI=confidence interval
«Wang Y, Wang K, Qin Y, et al. The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials. J Orth»1	Comparison A: 2 studies, 254 (126/128)	6 months	NA	NA	-0.08 (-0.33, 0.16)

Table 6. Extra long-term pain intensity in NRS scale of 0-10 (≥12 months))
Reference	Number of studies and number of patients (I/C)	Follow-up time	Mean (sd) I	Mean (sd) C	Std. Mean difference (95% CI)
Level of evidence: low The quality of evidence is downgraded due to study limitations and imprecision. One small trial using placebo as control did not measure medium or long-term follow ups. I=intervention; C=comparison; CI=confidence interval
«Wang Y, Wang K, Qin Y, et al. The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials. J Orth»1	Comparison A: 2 studies, 254 (126/128)	12 months	NA	NA	-0.27 (-0.52, -0.02)

Wang Y, Wang K, Qin Y, et al. The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2022;17(1):283 «PMID: 35598025»PubMed
Nissen MJ, Brulhart L, Faundez A, et al. Glucocorticoid injections for greater trochanteric pain syndrome: a randomised double-blind placebo-controlled (GLUTEAL) trial. Clin Rheumatol 2019;38(3):647-655 «PMID: 30267357»PubMed