Shockwave Therapy Versus Dry Needling for the Management of Iliotibial Band Syndrome: A Randomized Clinical Trial
AbstractBackground: Iliotibial band syndrome (ITBS) is a common leading cause of lateral knee pain. Despite varieties of medical and non-medical treatments proposed for the management of ITBS, the best therapeutic approach for its treatment remained a significant question. The current study aims to compare the outcomes of dry needling (DN) versus shockwave therapy (SWT) in the management of ITBS. Materials and Methods: This randomized clinical trial was conducted on 40 patients diagnosed with ITBS. The patients were randomly divided into two treatment groups of DN (n=20) and SWT (n=20). Visual analog scale for the pain assessment, Lower Extremity Functional Scale (LEFS) for the function evaluation, and length of the iliotibial band were assessed at baseline, immediately after the cessation of the intervention, and within four weeks. Results: The two groups were similar regarding demographic characteristics (P>0.05). Both approaches could efficiently lead to improved pain (P<0.001) and promoted function based on LEFS (P<0.001); however, iliotibial band length (ITBL) did not alter remarkably (P>0.05). The groups were similar in terms of pain score, LEFS, and ITBL at all of the assessment intervals (P>0.05), but the pain score within four weeks following the interventions that were significantly better in DN (P=0.023). Conclusion: Based on our results, DN, as well as SWT, could remarkably lead to an improvement in pain and function among patients resenting from ITBS; however, none of the approaches was superior over the other. [GMJ.2021;10:e2174]
Aderem J, Louw QA. Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review. BMC Musculoskelet Disord. 2015;16(1):1-16.
Pegrum J, Self A, Hall N. Iliotibial band syndrome. BMJ. 2019;364(1):l980-86.
Baker RL, Fredericson M. Iliotibial band syndrome in runners: biomechanical implications and exercise interventions. Phys Med Rehabil Clin N Am. 2016;27(1):53-77.
Lavine R. Iliotibial band friction syndrome. Curr Rev Musculoskelet Med. 2010;3(14):18-22.
Walbron P, Jacquot A, Geoffroy J-M, Sirveaux F, Molé D. Iliotibial band friction syndrome: An original technique of digastric release of the iliotibial band from Gerdy's tubercle. Orthop Traumatol Surg Res. 2018;104(8):1209-13.
Beals C, Flanigan D. A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population. J Sports Med (Hindawi Publ Corp). 2013;1(1):1-6.
Rahbar M, Eslamian F, Toopchizadeh V, Jahanjoo F, Kargar A, Dolatkhah N. A Comparison of the Efficacy of Dry-Needling and Extracorporeal Shockwave Therapy for Plantar Fasciitis: A Randomized Clinical Trial. Iranian Red Crescent Medical Journal. 2018;20(9):1-10.
Rayegani SM, Bayat M, Bahrami MH, Raeissadat SA, Kargozar E. Comparison of dry needling and physiotherapy in treatment of myofascial pain syndrome. Clin Rheumatol. 2014;33(6):859-64.
Walsh R, Kinsella S, McEvoy J. The effects of dry needling and radial extracorporeal shockwave therapy on latent trigger point sensitivity in the quadriceps: A randomised control pilot study. J Bodyw Mov Ther. 2019;23(1):82-8.
Walsh R. The effects of dry needling and radial extracorporeal shockwave therapy on the sensitivity of trigger points in the quadriceps and jump performance: A randomised control trial. Institute of Technology Carlow; 2017.
Shamus J, Shamus E. The management of Iliotibial band syndrome with a multifaceted approach: A double case report. Int J Sports Phys Ther. 2015;10(3):378-90.
Pavkovich R. The use of dry needling for a subject with chronic lateral hip and thigh pain: a case report. Int J Sports Phys Ther. 2015;10(2):246-55.
Pavkovich R. Effectiveness of dry needling, stretching, and strengthening to reduce pain and improve function in subjects with chronic lateral hip and thigh pain: A retrospective case series. International journal of sports physical therapy. 2015;10(4):540-51.
Weckström K, Söderström J. Radial extracorporeal shockwave therapy compared with manual therapy in runners with iliotibial band syndrome J Back Musculoskelet Rehabil. 2016;29(1):161-70.
Tabatabaei A EE, Ahmadi A, Sarrafzadeh J. Comparison between the effect of pressure release and dry needling on the treatment of latent trigger point of upper trapezius muscle. PTJ. 2013;3(3):9-15 [Persian].
Hong C-Z. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994;73(4):256-63.
Simons DG, Travell J, Simons LS. Myofascial pain and dysfunction: the trigger point manual: volume 1. 1999.
Kim J, Lee KS, Kong SW, Kim T, Kim MJ, Park S-B, et al. Correlations between electrically quantified pain degree, subjectively assessed visual analogue scale, and the McGill pain questionnaire: a pilot study. Ann Rehabil Med. 2014;38(5):665-72.
Negahban H, Hessam M, Tabatabaei S, Salehi R, Sohani SM, Mehravar M. Reliability and validity of the Persian lower extremity functional scale (LEFS) in a heterogeneous sample of outpatients with lower limb musculoskeletal disorders. Disabil Rehabil. 2014;36(1):1-6.
Mozey, A, Gholamhossienpour O, Nejati, P. The correlation of patellar position and iliotibial band length with body mass index in patients with anterior knee pain. JSKUMS. 2018;20(4):63-75.
Castro-Sánchez AM, Garcia-Lopez H, Mataran-Penarrocha GA, Fernández-Sánchez M, Fernández-Sola C, Granero-Molina J, et al. Effects of dry needling on spinal mobility and trigger points in patients with fibromyalgia syndrome. Pain Physician. 2017;20(2):37-52.
Unverzagt C, Berglund K, Thomas J. Dry needling for myofascial trigger point pain: a clinical commentary. Int J Sports Phys Ther. 2015;10(3):402-18.
Zhu H, Most H. Dry needling is one type of acupuncture. Medical Acupuncture. 2016;28(4):184-93.
Moghtaderi A, Khosrawi S, Dehghan F. Extracorporeal shock wave therapy of gastroc-soleus trigger points in patients with plantar fasciitis: A randomized, placebo-controlled trial. Adv Biomed Res. 2014;3(99):1-4.
Hong JO, Park JS, Jeon DG, Yoon WH, Park JH. Extracorporeal shock wave therapy versus trigger point injection in the treatment of myofascial pain syndrome in the quadratus lumborum. Ann Rehabil Med. 2017;41(4):582-8.
Moya D, Ramón S, Schaden W, Wang C-J, Guiloff L, Cheng J-H. The role of extracorporeal shockwave treatment in musculoskeletal disorders. JBJS. 2018;100(3):251-63.
Wang C-J. Extracorporeal shockwave therapy in musculoskeletal disorders. J Orthop Surg Res. 2012;7(1):11-8.
Gleitz M. Myofascial Syndromes and Triggerpoints: Level10 Buchverlag; 2019.
Galasso O, Amelio E, Riccelli DA, Gasparini G. Short-term outcomes of extracorporeal shock wave therapy for the treatment of chronic non-calcific tendinopathy of the supraspinatus: a double-blind, randomized, placebo-controlled trial. BMC musculoskelet disord. 2012;13(1):86-95.
Zamzam M, El Yasaki A, ElGarabawy N, El Ghandour LEE. Shockwave therapy versus local steroid injection in chronic supraspinatus tendinopathy. Egypt Rheumatol Rehabil. 2019;46(3):141-7.
Del Castillo F, Ramos Álvarez JJ, Rodriguez Fabián G, González Pérez J, Jiménez Herranz E, Varela E. Extracorporeal shockwaves versus ultrasound-guided percutaneous lavage for the treatment of rotator cuff calcific tendinopathy: a randomised controlled trial. Eur J Phys Rehabil Med. 2016;52(2):145-51.
Knobloch K, Kuehn M, Vogt PM. Focused extracorporeal shockwave therapy in Dupuytren's disease-a hypothesis. Med Hypotheses. 2011;76(5):635-37.
Maffulli N, Maffulli G. The assessment of the effectiveness of extracorporeal shock wave therapy (ESWT) for soft tissue injuries (ASSERT): two year results. MLTJ. 2018;8(3):46-51.
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