Neuromodulation
Schan Lartigue, MD
Resident, PGY-2
Yale New Haven Hospital
New Haven, Connecticut, United States
Sergio Mosquera Limas, DO
Resident, PGY-2
Yale New Haven Hospital
New Haven, Connecticut, United States
Mustafa R. Dodurgali, MD
Resident Physician
Yale School of Medicine
New Haven, Connecticut, United States
Charles A. Odonkor, MD, MA, FAAPMR
Assistant Professor of Orthopedics & Rehabilitation
Yale University School of Medicine
NEW HAVEN, Connecticut, United States
Schan M. Lartigue, MD
Yale New Haven Hospital
New Haven, Connecticut, United States
Refractory greater trochanter pain syndrome (GTPS) and concomitant chronic bilateral low back pain.
Case Description: A 40-year-old woman presented with longstanding bilateral low back pain and debilitating right hip pain, consistent with GTPS, that was unresponsive to physical therapy, multiple corticosteroid injections, and oral analgesics. Given her refractory symptoms, she underwent a 60-day peripheral nerve stimulation (PNS) treatment targeting the greater trochanteric branch of the right femoral nerve. This resulted in complete resolution of hip pain during the treatment period; however, symptoms recurred one month after lead explant. Given the transient benefit and concurrent low back pain, a dorsal root ganglion (DRG) stimulation trial was pursued. Permanent implantation of bilateral S1 and right L1–L2 DRG leads was performed under fluoroscopic guidance following a successful trial. Post-implantation, the patient reported a 75% reduction in pain with durable improvement in function and high satisfaction at follow-up. No complications were observed.
Discussions:
Neuromodulation is an expanding field in interventional pain medicine that modulates abnormal nociceptive signaling via targeted electrical stimulation of peripheral or spinal neural structures. GTPS is a frequent cause of lateral hip pain that is often refractory to conservative management; in severe cases, arthroscopic or surgical interventions are considered. This case highlights the utility of neuromodulation—through PNS and DRG stimulation—as a minimally invasive alternative for refractory GTPS and low back pain. To our knowledge, this is among the first reported cases of peripheral nerve and DRG stimulation for GTPS, underscoring their potential role in addressing pain syndromes that extend beyond traditional axial or radicular distributions.
Conclusions: Neuromodulation represents a promising therapeutic strategy for chronic refractory GTPS. This case demonstrates clinically meaningful, durable pain relief and functional gains, supporting further investigation into the role of targeted neuromodulation in refractory pain syndromes where conservative and injection-based therapies fail.
