Effectiveness of High Intensity Laser Therapy in Patients With Greater Trochanteric Pain Syndrome

This single-center, randomized controlled trial was conducted at the Physical Medicine and Rehabilitation Clinic of Uşak Training and Research Hospital. Participants had lateral hip pain lasting at least 3 months. The diagnosis was based on clinical examination and supported by magnetic resonance imaging.

Participants were assigned to exercise alone or high-intensity laser therapy plus exercise using a computer-generated random number list. The trial was open-label. Participants, the treating physiotherapist, and the physician performing the assessments knew the treatment assignments. No sham laser treatment was used.

The exercise program included gluteal muscle activation, hip abductor strengthening, pelvic stabilization, stretching, and functional exercises. A physician taught the exercises. Participants were instructed to perform three sets of 10 repetitions for each exercise. Exercise intensity and progression were adjusted to pain tolerance and functional capacity. Adherence was monitored through weekly telephone calls.

An experienced physiotherapist applied laser treatment around the greater trochanter and the gluteus medius and minimus tendon insertions. Both the participant and the physiotherapist wore protective eyewear. Participants were monitored for adverse events during and after treatment.

• Exercise Program (Behavioral): Participants performed a standardized hip exercise program three days per week for 8 weeks. A physician taught the exercises. The program included gluteal muscle activation, hip abductor strengthening, pelvic stabilization, stretching, and functional closed kinetic chain exercises. Exercise intensity and progression were adjusted to each participant's pain tolerance and functional capacity. Adherence was monitored through weekly telephone calls.
• High Intensity Laser Therapy (Device): High intensity laser therapy was applied to the greater trochanteric region and the painful insertion sites of the gluteus medius and gluteus minimus tendons twice weekly for 4 weeks, for a total of 8 sessions. Each session lasted 15 minutes. Both the participant and the therapist wore protective eyewear during each session.

Primary outcomes

• Total Harris Hip Score (HHS) [Baseline, 1 month after treatment initiation, and 3 months after completion of the 8-week exercise program.]: Hip pain and function were assessed using the Harris Hip Score (HHS). The score includes pain, function, deformity, and range of motion. Total scores range from 0 to 100, with higher scores indicating better hip status. The total HHS was the primary outcome measure.

Secondary outcomes

• Pain intensity measured by the Visual Analog Scale (VAS) [Baseline, 1 month after treatment initiation, and 3 months after completion of the 8-week exercise program.]: Lateral hip pain during daily activities was assessed using a 10-cm Visual Analog Scale (VAS). Scores range from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Lower scores indicate less pain.
• SF-36 [Baseline, 1 month after treatment initiation, and 3 months after completion of the 8-week exercise program.]: Health-related quality of life will be assessed using the Short Form-36 (SF-36) questionnaire. The SF-36 evaluates eight domains of health, including physical functioning, role limitations due to physical health, role limitations due to emotional problems, vitality, mental health, social functioning, bodily pain, and general health. Higher scores indicate better health-related quality of life. In this study, the SF-36 will be used as a secondary outcome measure to evaluate changes in health-related quality of life.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Age 18 years or older.
* Clinical diagnosis of greater trochanteric pain syndrome (GTPS), supported by magnetic resonance imaging (MRI).
* Lateral hip pain lasting at least 3 months.
* Baseline Visual Analog Scale (VAS) pain score of at least 4 out of 10.
* Ability to understand and complete the assessment forms.
* No participation in regular sports during the previous 6 months.
* Provision of written informed consent.

Exclusion Criteria:

* Previous surgery on the affected hip.
* Advanced hip osteoarthritis.
* Lumbar radiculopathy or a neurological disease affecting lower limb function.
* History of inflammatory rheumatic disease.
* Active infection or malignancy.
* Corticosteroid injection in the trochanteric region within the previous 3 months.
* Participation in a physical therapy or rehabilitation program for GTPS within the previous 3 months.
* Pregnancy.
* Any contraindication to high-intensity laser therapy (HILT).
* Inability to follow the treatment or follow-up protocol.