Effect of Dry Needling Combined with a Structured Exercise Programme versus Manual Therapy Combined with a Structured Exercise Programme on Pain in Athletes with Iliotibial Band Syndrome: A Comparative Study

Abstract

Background:
Iliotibial Band Syndrome (ITBS) is one of the most common overuse injuries affecting athletes involved in
repetitive running and jumping activities. The condition is characterized by lateral knee pain that interferes with
athletic performance and functional training. Exercise-based rehabilitation remains the cornerstone of
conservative management; however, adjunctive interventions such as manual therapy and dry needling are
frequently incorporated to improve pain relief. Despite their widespread clinical use, evidence directly
comparing the pain-relieving effects of these interventions when combined with the same structured exercise
programme remains limited.
Objective:
To compare the effectiveness of Dry Needling combined with a structured exercise programme and Manual
Therapy combined with the same exercise programme on pain intensity in athletes with Iliotibial Band
Syndrome.
Methods:
A comparative interventional study was conducted among 60 athletes aged 18–40 years with clinically diagnosed
Iliotibial Band Syndrome. Participants were randomly allocated into two equal groups. Group A received Manual
Therapy with a structured exercise programme, whereas Group B received Dry Needling with the same exercise
programme. Both groups underwent supervised treatment five sessions per week for six weeks. Pain intensity
was assessed using the Visual Analogue Scale (VAS) before and after the intervention. Within-group and
between-group comparisons were performed using paired and independent t-tests, with statistical significance
set at p < 0.05.
Results:
Both intervention groups demonstrated statistically significant reductions in pain following six weeks of
treatment (p < 0.001). The Manual Therapy group improved from 6.50 ± 1.11 to 5.43 ± 0.86, whereas the Dry
Needling group improved from 6.50 ± 1.11 to 3.57 ± 0.90. Between-group analysis demonstrated significantly
greater pain reduction in the Dry Needling group compared with the Manual Therapy group (p < 0.001).
Conclusion:
Both Manual Therapy and Dry Needling, when combined with a structured exercise programme, effectively
reduced pain in athletes with Iliotibial Band Syndrome. However, Dry Needling produced significantly greater
short-term pain reduction and may be considered the preferred adjunctive intervention for pain management
during conservative rehabilitation