| Months 1–6 (Pre-Treatment) | Received 2 cortisone injections into the greater trochanteric bursa — each provided weeks of relief before pain returned. Completed PT focused on hip strengthening, but lateral hip pain persisted with walking and stair climbing. |
| ▸ Treatment at City Integrative Rehabilitation | |
| Condition | Greater trochanteric pain syndrome (hip bursitis) |
| Duration | 8 months |
| Activity Level | Recreational walker/hiker (3–5 miles daily) |
| Prior Treatment | 2 cortisone injections, PT hip strengthening |
| Primary Impact | Cannot sleep on left side, limited walking distance |
The Presenting Complaint
A 55-year-old recreational walker loved her daily 3–5 mile walks and weekend hiking trips. Eight months ago, her left hip started hurting on the outside—classic greater trochanteric pain syndrome. The pain was severe enough that sleeping on her left side had become impossible. She’d tried two cortisone injections, both of which provided temporary relief before the pain returned. Physical therapy focused on hip strengthening, but the pain persisted.
When she came to us, she had adapted her life around the pain: shorter walks, sleeping on her right side, reduced hiking. She wanted to know if there was anything else to try before accepting that her walking days might be behind her.
Treatment Approach
Focused Extracorporeal Shockwave Therapy (F-ESWT)
We applied focused shockwave therapy to the greater trochanter (the bony bump on the outside of the hip). The evidence shows that F-ESWT outperforms cortisone injections long-term for hip bursitis. Unlike cortisone, which only suppresses inflammation temporarily, shockwave triggers tissue healing and remodeling. We completed six sessions over four weeks.
Dynamic Neuromuscular Stabilization (DNS)
We identified that her hip abductors (especially the gluteus medius) weren’t functioning optimally. This meant her pelvis was dropping with each step, putting repetitive stress on the bursa. We retrained her glute activation patterns using DNS techniques so her pelvis would stay level and stable during walking.
Chiropractic Pelvic Alignment
We addressed any underlying pelvic alignment issues through chiropractic care, ensuring that her hip joint was moving from a mechanically sound position.
Phase 1 Weeks 1–2 | F-ESWT (2 sessions), DNS hip abductor and glute med activation, chiropractic pelvic assessment and alignment, pain management |
Phase 2 Weeks 3–4 | F-ESWT (2 remaining sessions), DNS progression for single-leg balance and proprioception, modified walking mechanics, continued chiropractic support |
Phase 3 Weeks 5–6 | F-ESWT (2 final sessions), return to full walking distance, hiking at moderate intensity, maintenance DNS and proprioception work |
Recovery Timeline
| Week 4 | Walking 4–5 miles daily without pain; glute med firing strongly during single-leg stance; pelvic alignment stable |
| Week 6 | Hiking 5+ miles on varied terrain pain-free; normal sleep position; full return to pre-injury activity level |
The Outcome
Within 6 weeks, she was walking and hiking pain-free, sleeping on her preferred side, and back to her full activity level. Unlike the cortisone injections that kept bringing the pain back, the combination of tissue healing (F-ESWT) and movement correction (DNS) provided lasting resolution. Twelve months later, she remains pain-free and has maintained her walking and hiking routine. The key was addressing both the tissue inflammation and the biomechanical reason it kept returning.
Disclaimer: This case study represents one patient’s experience and is provided for educational purposes only. Results vary based on individual factors, condition severity, and adherence to treatment. This is not a guarantee of outcomes. Always consult with a qualified healthcare provider before starting any treatment program.
Related: F-ESWT | DNS | Chiropractic Care