Anatomical leg length inequality is the difference in actual bone length of one leg compared to the other. In some studies, 5 mm (3/16 of an inch) difference is considered significant, and can affect the successful outcome of chronic low back pain treatment.
The greatest problem caused by leg length inequality is low back pain. Ora Friberg, M.D. did a study and published an article in Spine 1983 (Vol. 8 Number 6 Pages 643-651) titled Clinical Symptoms and Biomechanics of Lumbar Spine and Hip Joint in Leg Length Inequality.
The study consisted of 798 chronic low back pain patients with a control group of 359 non-low back pain patients. He found 43.5% of the control group had leg length inequality of 5 mm or more. But more importantly, he found that 75.4% of chronic back pain patients had length inequality of 5 mm or more. One could then determine that leg length inequality is a significant factor in the cause of low back pain.
The second most common problem caused by leg length inequality is pain in the hip, knee or leg on the side of the longer leg. Studies have shown that the longer leg carries more weight, and is subject to more abuse in activities such as walking, or running. Long standing Leg length inequality has been shown to lead to hip joint arthritis. Because of these complications, experts believe that anyone suffering from chronic back, hip, knee, or leg pain be evaluated for leg length inequality.
Authorities suggest the treatment of chronic low back pain complicated by leg length inequality be a two part process. The first consideration being spinal manipulation to reduce misalignments and muscular tightness in the lower back and pelvis, which are normal occurrences with leg length inequality.
Second is the utilization of a heel lift under the short leg side to stabilize and level the pelvis, thereby giving the spine a more level foundation on which to rest. A level foundation reduces wedging of the intervertebral discs, sheer stress on the spinal joints, rotational distortions of the vertebrae, and normalizes lower back muscular balance. This two–step process will help to correct the most chronic low back and hip pain problems in a high percentage of cases.
Even though it is an important factor, leg length inequality is commonly overlooked in the evaluation of low back, hip, and leg pain problems. Anyone with back, hip, or leg pain should have a thorough examination to determine if leg length inequality is a factor in his or her condition.
To Our Patients and Their Families and Friends:
Our office takes great pride in providing the best care available for those suffering from leg length inequality and associated back pain. We welcome your referrals to our office for cases of those with this problem. You have our pledge that we will do everything possible to help those patients whom you refer to us.
Dr. Joseph Gitto
331 Tilton Road Suite #12 Northfield, NJ 08225