ITB (Iliotibial Band) and Greater Trochanter Pain- Difficult to Treat!

The ITB, also known as the iliotibial band, is a band of tissue that travels down the outside of the leg. It originates at the side of the hip bone, which is the Greater Trochanter. Pain at the outside of the leg and at the outside of the hip joint is very common. We see this regularly in sports participation, or as a sequelae to altered gait with limping, or from injuries that impact the outer leg.
Many times, soft tissue injuries in these areas will respond quickly to treatment with Osteopathic manipulation, acupuncture, or Pulsed Electromagnetic Field Therapy, (PEMF).
However, we see many cases in which treatment has been provided elsewhere for weeks or months without improvement, leading to significant patient frustration. These therapeutic attempts are usually inadequate because of a lack of understanding of the actual problem.
For example, if the pain is from altered gait from an ankle or knee injury, this must be addressed before the ITB can heal. Or, the persistence of pain may be caused by the spine, pelvis, knee or ankle being out of their ideal position, requiring Osteopathic manipulation for correction. There might also be tendon or ligament injury at the greater trochanter which will not heal with physical therapy and exercises, but will respond to Prolotherapy. Then again, these same areas can be sources of radiating pain from the low back, even if there is no concurrent back pain.
The first step, then, in successfully treating pain of the ITB and the Greater Trochanter, is identifying the true source of the pain. This can usually be done with a thorough physical exam, although X-ray studies or an MRI may be necessary.
Next, the treatment is chosen to match the source of the pain:
If the injury only involves soft tissue damage with displacement of bony structures, rapid response is usually seen with Osteopathic Manipulation and prescribed exercises. Pulsed Electromagnetic Field Therapy (PEMF) or acupuncture may be added to accelerate healing.
If bursitis of the Greater Trochanter is evident, we may employ an injection of either an Homeopathic anti-inflammatory agent or perhaps a steroid.
If the area has been hurting for quite some time, and ligament or tendon damage is involved, then Prolotherapy will usually resolve the problem.
Finally, if there is spinal involvement, this will significantly complicate the problem and must also be addressed.
If you have pain at the outside of the upper leg, it is most likely from the Greater Trochanter or the Iliotibial Band, and we can help!

About the Author

Dr. Teitelbaum practices Osteopathic manipulation, prolotherapy, spinal decompression, acupuncture, and Chinese herbal medicine in the Dallas/Ft. Worth metroplex. For over 25 years, he has provided conservative, natural treatment for sports injuries, back pain, neck pain, headaches, posture problems, overuse injuries, and joint pain. Commonly treated conditions include muscle, tendon and ligament damage of the neck, low back, tailbone, shoulder, elbow, wrist, hand, hip, knee, ankle and foot.