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Dry needling may be viable alternative to cortisone injection for hip pain

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Patients with hip pain can benefit from a treatment known as dry needling, according to new research.

Dry needling uses filament needles to stimulate sensitive loci, or trigger points, in the muscles. In a study published in the Journal of Orthopaedic & Sports Physical Therapy (JOSPT), it was found to be just as effective as cortisone injection in reducing pain and improving movement problems caused by greater trochanteric pain syndrome (GTPS).

This condition -- which used to be called greater trochanteric or subgluteal bursitis -- causes chronic, intermittent pain and tenderness on the outside of the hip. It is estimated to affect 10% to 25% of the general population.

As JOSPT explains, the medical community once thought that a swollen hip bursa -- a fluid-filled sac that acts as a gliding surface to reduce friction between moving tissues in this joint -- was the source of this hip pain. This conclusion led to the use of steroid injections to the bursa to help decrease swelling and pain. However, evidence now indicates that injuries to the muscles and tendons around the hip are the actual cause of this pain, and that inflammation is often not involved, raising questions about injecting the bursa with a steroid.

"The potential detrimental side effects of steroid injection, particularly repeated injections, are of concern for patients and providers alike," commented lead author Dr Kindyle L. Brennan from Baylor Scott & White Health. Because of this, "the identification of a comparable treatment alternative with minimal side effects, such as dry needling, offers valuable clinical advantages," she said.

The study involved 43 patients with GTPS who were randomly assigned to one of two groups for six weeks of treatment. One group received cortisone injections and the other group received dry needling.

To assess how effective the two treatments were, the researchers collected clinical outcomes at the start of the trial and at one, three and six weeks. They also measured pain and function in the hip and collected information about medication intake for pain in the hip.

Results showed that cortisone injection did not provide better outcomes than dry needling for either pain or function. Both groups experienced a decrease in pain and an improved ability to move and complete daily activities.

Additional studies over longer time periods would help to confirm the findings of this study, Dr Brennan said.

https://www.eurekalert.org/pub_releases/2017-04/jidm-dno041017.php

http://www.jospt.org/doi/abs/10.2519/jospt.2017.6994

April 19 2017

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