Intended for healthcare professionals


Comparison of fluoroscopically guided and blind corticosteroid injections for greater trochanteric pain syndrome: multicentre randomised controlled trial

BMJ 2009; 338 doi: (Published 14 April 2009) Cite this as: BMJ 2009;338:b1088

Acupuncture treatment of Trochanteric Bursitis

Dear Sir,

I was interested to read the article from the BMJ 2009;338;b1088 on the
comparison between fluoroscopically guided and blind injections for
greater trochanteric pain syndrome; in particular that most steroid
injections are positioned outside the bursa.

I have been a practising acupuncturist for over 25 years, initially
training in China.
I have treated many patients with this condition, as a single-handed GP,
where one or two treatments usually suffices, as well as in the
rheumatology clinic(1,2), where patients have often had unsuccessful
steroid injections or physiotherapy in the past. I audit my results and
find that I have had sometimes to treat up to six times with an average
improvement in pain of approximately 75%.

I have mainly treated the trigger (tender)points of gluteus medius and
minimus(surrounding the trochanteric bursa), which presumably are due to a
small tear or abnormal contraction of muscle. Ultrasound has not normally
been available to make a diagnosis.Occasionally there are trigger points
along the iliotibial band, which I also treat.The steroid injection may be
producing an acupuncture effect from the needle, releasing contracted
muscle, causing the release of endogenous encephalins or by the delivery
of cells which stimulate healing.

Rosemary Alexander(Dr) MRCP Dip Ac(Shanghai)

1)Alexander RE,White AR Acupuncture in a Rheumatology
Clinic.Acupuncture in Medicine Dec 2000 VOL 18(2)

2)Alexander RE,White AR Acupuncture in a Rheumatology Clinic. Rheumatology
April 2001;VOL 40;412

Competing interests:
None declared

Competing interests: No competing interests

29 April 2009
Rosemary E Alexander
Hospital Practitioner Rheumatology
Edgware Community Hospital,Edgware,HA8 OAD