Iliotibial Band Syndrome posted by : Dr. Barnetton: 21 September, 2017
Iliotibial band syndrome is so common in my interventional pain practice, I keep an illustration, (below), on my desktop for teaching.  Its pathway is obvious in the picture and the elementary diagnosis simply requires touching it to determine its involvement.  It overlies the Trochanteric bursa, the common inflammatory source, and in athletes, knee bursa, a common source of inflammation.  Daily I see and treat this with anti-inflammatories; injected into the bursa, applied topically, as well as systemically.  It is most commonly present with gait disturbance, pelvic tilt, or other alignment issues.  Often resistant to treatment without antiinflammatories.
image-10 The greater trochanteric bursa is a fluid-filled sac that essentially serves to lubricate the attachments inserting onto the bony prominence of the lateral hip, called the greater trochanter. Patients often confuse the linear pattern with a nerve pathway, referring to it as Sciatica.  They often put pillows between they’re legs trying to improve sleep patterns. Without treatment of the underlying cause it is extremely resistant to treatment.  Diagnosis is simple:  “if you touch it and it hurts, it is more than likely the thing you are touching, versus some distant body part or other referred pain signal.
image-11The typical stretch for the IT band also effectively stretches the Piriformis muscle, often associated with this syndrome. Heat, constant stretching, anti-inflammatories, stabilization of gait and associated diagnoses is key to successful treatment. Without those elements this can be an extremely resistant pathology, creating a disproportional amount of disability, often lending one to search for more significant etiologies.
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