What is the treatment for iliotibial band (IT band) syndrome?
Iliotibial band syndrome is an overuse injury that causes inflammation. Initial treatment includes rest, ice, compression, and elevation (RICE).
Anti-inflammatory medications, like ibuprofen (Advil, Motrin) and naproxen (Aleve), may be helpful. Note that any over-the-counter medications can have potential side effects, as well as interactions with prescription medications. If questions or concerns exist, it is wise to ask a health-care professional or pharmacist about their safe use.
Home treatment can involve stretching, massage, and use of foam rollers at the site of pain and inflammation.
Should these first-line treatments not work, physical therapy may be needed to decrease the inflammation at the IT band. Some treatments focus on flexibility and stretching. Friction rubbing may occur over the IT band at the femoral epicondyle may help to break down inflammation and scarring.
Therapeutic ultrasound techniques may be used, including phonopheresis (ultrasound propels anti-inflammatory medications through the skin into the inflamed tissue) and iontophoresis (electricity is used instead of ultrasound) to help decrease irritation in the soft tissues surrounding the knee.
The physical therapist may also help evaluate the underlying cause of the problem and look at muscle strength and balance and/or flexibility and gait analysis (watching a person walk, run, or cycle). Shoe orthotics may be useful if there is a gait problem, pelvic tilt, or leg-length discrepancy as a potential cause of IT band syndrome.
Corticosteroids (dexamethasone, methylprednisolone, hydrocortisone) injected at the site of inflammation may be of benefit.
It is unusual that the conservative nonsurgical treatment fails to help. However, orthopedic surgery may be an option for patients who fail conservative (nonoperative) treatment. Arthroscopy can be used to find the inflammation surrounding the iliotibial band and cut it away. This inflammation and scarring is often found in the lateral recess of the knee between the IT band and the femoral epicondyle. Other surgical options may be available, including cutting out a small triangular part of the IT band to lengthen the band and allow more room for it to slide across bone. Before surgery is considered, other potential causes of lateral knee pain are usually considered. These include lateral meniscus tear and chondromalacia.