The iliotibial band (Latin: tractus iliotibialis; ITB) is most commonly associated with patellofemoral pain syndrome, also referred to as runner's knee. However, the impact of its imbalance on the lumbar spine is substantial and frequently overlooked. As a significant thickening of the fascia lata, the iliotibial band serves as a crucial component for the lateral stabilization of the entire kinematic chain of the lower extremity and the pelvis. Restricted tissue gliding, gluteus medius insufficiency and weakness of the core musculature may present as primary contributors to pain syndromes manifesting in the lumbar region of the spine. This article highlights the relationship between the dysfunction of the iliotibial band and chronic lumbar spine pain to propose a comprehensive rehabilitation approach. This approach should include soft tissue relaxation techniques, loading of muscle structures, and correction of movement patterns. The attention given to the flexibility of the iliotibial band allows for a substantial reduction in the pain of the sacroiliac region.