Greater trochanteric pain syndrome (GTPS), commonly called hip bursitis, can frustrate patients and providers alike. Lateral hip pain may persist despite rest, stretching, adjustments, medication, or injections. For chiropractors, GTPS creates an opportunity to combine precise assessment, progressive rehabilitation, and high-intensity shockwave therapy into a structured, non-invasive care plan.
JointWave™ delivers powerful acoustic energy into soft tissue, joints, and tendons. Used appropriately, it can complement chiropractic care by helping address the soft-tissue component of stubborn lateral hip pain: without drugs, injections, or surgery.
Clinical note: This article provides an evidence-informed framework, not a substitute for professional judgment, diagnostic imaging, referral, or the manufacturer’s instructions. Screen every patient carefully and practice within your state’s scope of care.
Better Assessment. Better Targeting. Better Outcomes.
Understand what “hip bursitis” really means
GTPS describes pain around the lateral aspect of the hip. Trochanteric bursitis may contribute, but many patients also present with gluteus medius or gluteus minimus tendinopathy, tendon thickening, or irritation at the gluteal tendon attachment.
That distinction matters. A protocol focused only on reducing bursal irritation may miss the tendon and load-management factors driving the patient’s symptoms.
Common findings include:
- Pain over the greater trochanter
- Discomfort when lying on the affected side
- Pain with prolonged walking, stairs, running, or standing on one leg
- Weakness or pain during resisted hip abduction
- Reduced tolerance for single-leg activities
- Symptoms that worsen after sudden increases in training or activity
Your evaluation should also consider lumbar referral, hip osteoarthritis, labral pathology, sacroiliac-region pain, proximal hamstring disorders, and other causes of lateral hip symptoms. Refer or co-manage when red flags, unexplained systemic symptoms, significant trauma, neurological findings, infection, or suspected fracture appear.
Treat the Tissue. Restore the Load. Rebuild Function.
Why shockwave therapy may help
Shockwave therapy uses mechanical acoustic pulses to stimulate a biological response in the treated tissue. The proposed process involves mechanotransduction: cells respond to mechanical energy by altering signaling, local circulation, and tissue-repair activity.
The clinical goal is not simply to “numb” the hip. The goal is to create a better environment for recovery while the patient progressively reloads the hip through exercise.
Potential benefits include:
- ✅ Non-invasive treatment for persistent soft-tissue pain
- ✅ A complementary option when exercise alone has not restored function
- ✅ Support for blood flow and local tissue response
- ✅ A way to address deeper structures than many superficial modalities
- ✅ Short treatment sessions that fit into an existing chiropractic schedule
The evidence supports cautious optimism rather than guaranteed results. A 2024 systematic review of eight randomized controlled trials involving 754 patients found that ESWT produced lower pain scores than comparison treatments at two to four months. Focused ESWT performed better than radial ESWT for pain reduction. Functional scores improved at six months, although the average improvement did not exceed the study’s minimal clinically important difference.
In other words, shockwave therapy may reduce pain and support function, but patient selection, rehabilitation, dosing, and follow-up still determine clinical value.
Select Carefully. Educate Clearly. Document Everything.
Build the right patient profile
A practical JointWave protocol may suit adults with clinically consistent GTPS who have experienced persistent symptoms despite an appropriate trial of conservative care.
Consider JointWave when the patient has:
- ✅ Lateral hip pain lasting several weeks to months
- ✅ Local tenderness around the greater trochanter or gluteal tendon attachment
- ✅ Functional limitations during walking, stairs, sleep, or exercise
- ✅ A documented trial of load modification and progressive exercise
- ✅ A goal of returning to work, sport, or normal daily activity
Set expectations before the first session. Explain that the therapy may feel intense, and the patient may experience temporary soreness, redness, or bruising. Improvement may develop over several weeks rather than immediately. NICE guidance recommends informed consent, clinician training, outcome monitoring, and special governance arrangements for ESWT in refractory GTPS because the evidence base remains limited and variable.
Track baseline pain, sleep tolerance, walking capacity, single-leg tolerance, and a validated functional measure such as the Lower Extremity Functional Scale. Consistent documentation helps you determine whether the treatment is helping and supports a responsible cash-based service.
Three Sessions. One Weekly Rhythm. A Complete Care Plan.
An evidence-informed treatment framework
The best-studied focused ESWT trial for GTPS used three weekly sessions combined with a specific exercise program. The study protocol delivered approximately 2,000 impulses per session at an energy flux density of about 0.20 mJ/mm², with the treatment directed toward the greater trochanter and gluteal tendon attachment.
Those parameters should serve as a reference point: not a universal prescription. JointWave clinicians should use the settings taught during training and follow the device’s instructions for use. Treatment intensity, pulse count, coupling, patient tolerance, and target depth should reflect the individual patient and the specific JointWave applicator.
A practical workflow may look like this:
1. Assess and map
Identify the most symptomatic structures through history, palpation, resisted testing, and imaging when indicated. Mark the greater trochanter, gluteal tendon attachment, and surrounding soft tissue. Avoid treating blindly when the presentation is unclear.
2. Prepare the patient
Position the patient comfortably, explain expected sensations, and apply appropriate coupling medium. Start conservatively and communicate throughout the session. Do not treat through open skin, active infection, or an area requiring medical referral.
3. Deliver targeted acoustic energy
Apply JointWave energy to the clinically relevant region using trained technique and manufacturer-recommended settings. Avoid treating directly over vulnerable neurovascular structures. Adjust intensity based on patient response while maintaining a purposeful therapeutic target.
4. Add progressive rehabilitation
Shockwave therapy works best as part of a broader plan. Begin with tolerable isometric hip-abductor work, then progress toward strengthening the gluteus medius and minimus, lumbopelvic control, and functional single-leg loading.
Educate patients to reduce sustained compression on the lateral hip. They may need to avoid lying directly on the painful side, crossing the legs for long periods, or abruptly increasing running, hiking, or stair volume.
5. Reassess at every visit
Record pain during a meaningful activity, functional changes, adverse effects, and exercise tolerance. A patient who reports less pain but still cannot walk, sleep, or climb stairs has not completed the outcome assessment.
Focused Energy. Deeper Reach. Smarter Positioning.
Not every device marketed as “shockwave” delivers the same type of energy. Radial pressure waves spread outward and lose energy closer to the surface. Focused shockwaves concentrate energy into a smaller focal zone and have stronger RCT-level evidence in GTPS.
That distinction becomes important when the suspected pain generator sits deeper around the gluteal tendon attachment or greater trochanter.
Your clinical decision should consider:
- ✅ Depth of the target tissue
- ✅ Device output and applicator design
- ✅ Treatment-head precision
- ✅ Patient tolerance
- ✅ Your training and scope of practice
- ✅ The rehabilitation plan surrounding treatment
JointWave treatment heads are technologically superior and built to outlast major competitors, supporting a better long-term return on investment for your practice. Durable treatment heads can reduce replacement costs, limit downtime, and help your team deliver consistent care over time.
Better Care. Better Efficiency. Better Practice Growth.
GTPS care can also strengthen your clinic’s service model. Each session can fit into a focused appointment or complement an existing chiropractic visit. That creates a practical way to offer a non-invasive, cash-based service while helping patients pursue measurable functional goals.
JointWave supports implementation beyond the device itself:
- ✅ White-glove installation
- ✅ Staff training and clinical education
- ✅ Patient-facing marketing materials
- ✅ Guidance for integrating treatment into care plans
- ✅ A 30-day in-office trial with no obligation
This reduces the risk of adding a new modality. Your team can evaluate workflow, patient response, scheduling, and demand before making a long-term decision.
Read more about integrating shockwave therapy with chiropractic adjustments, or review the business case for shockwave therapy in chiropractic clinics.
Start Carefully. Measure Consistently. Grow Confidently.
Greater trochanteric pain syndrome requires more than a quick modality. The strongest approach combines accurate assessment, targeted acoustic energy, load management, progressive exercise, and honest follow-up.
Current evidence suggests that three weekly ESWT sessions may provide short-term pain relief, particularly when clinicians use focused treatment and combine it with rehabilitation. It does not eliminate the need for clinical reasoning. It makes clinical reasoning more valuable.
If your practice wants a deeper, non-invasive option for persistent lateral hip pain, try JointWave risk-free in your own office for 30 days. Your team can experience the workflow, evaluate patient response, and decide without a long-term obligation.
Visit JointWave to start your no-obligation trial.