Leg length inequality and low back pain

Leg length inequality and low back pain has research from the Journal of Rheumatology.



"Leg length inequality and low back pain go hand in hand"

rheumatologist J. Philip Gofton, MD.



"Patients with low back pain who were found to have leg length discrepancy were treated with a lift to the shoe on the short leg side. This treatment can have major or total relief of symptoms over a long period of follow-up."





Gofton's research reveals that

A leg length difference of 12.5 mm will cause a lateral tilt of the sacrum of about 4° with a compensatory scoliosis in the lumbar spine.

The resulting disparity of forces “must demand a counter effort from structures in the lower spine."


Common Symptoms

  • Low back pain is a chronic problem that comes on within 20 or 30 minutes of being upright, and is relieved quickly with sitting.

  • Medial cartilage degeneration on the long [leg] side has been observed. (presumably knee cartilage)

  • Pain at the greater trochanter

  • Patients have commented that a troublesome ache at the base of the neck was improved together with their chronic low back pain.


    Gofton concludes

    The effect of leg length disparity and hip arthritis has been documented. These observations suggest that distorted biomechanics and stresses throughout the body produced by what would initially seem to be a trivial asymmetry deserve more searching investigation.



    HIP ARTHRITIS ...





    "Great site but I would like to pass on some feedback. If you could add a warning on the hip lift for people with upper lumbar herniations. I have a herniation at l2-3 and tried the hip lift since my symptoms were almost identical to those described. I worsened my symptoms with the worst pain of my entire life in the groin area. I blame myself for not checking first with my physio. Having said that, Maybe put a warning for folks with lumbar herniations. I understand it's meant more for people with the issue arising from the hip, but some folks may have both.

    Might be fine for others but that was my experience. My Symptoms seem to be settling down a bit now and i've learned my lesson on self treatment. Desperation with pain sonetimes drives us to do things we shouldn't. The other stretches seemed great btw.

    Thanks, James"



    An anecdote

    One patient in the series, a physician, had a recalcitrant plantar wart which defied all treatment until his disparity was corrected. His back pain and the wart disappeared. Both reappeared when he omitted the lift in his shoe a year later and both disappeared on resumption of the correction.

    This somato-visceral anecdote from a respected medical journal is not without significance.

    LEG LENGTH INEQUALITY CaseFile ...

    Common practice in LEG LENGTH INEQUALITY and LOW BACK PAIN

    States Gofton "The suggestion that leg length disparity can produce low back pain has been known since before the turn of the century (20th) and although lip service has been paid to it by physicians it is not a matter taught in medical schools nor addressed seriously by most clinicians. Osteopaths make much of it and irregular healers of various kinds espouse it.”



    Chiropractic

    In speaking of 'irregular' healers Gofton is almost certainly referring to the Chiropractic profession. Medicine has come a long way since 1985 in recognising us, but even here Gofton is being complimentary to our profession.

    Has any Chiropractic research been done? What proportion of chiropractors still give only lip service to the importance of Leg Length Inequality and Low Back Pain.

    For myself, Gofton has given impetus to recent thoughts: Does a heel lift also have a place in the routine and regular Chiropractic management of recalcitrant neck pain?

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