Leg Length and Lower Back Pain
By Curtis Whitehair, M.D.

Finally, an answer to that nagging question: Can leg-length discrepancy be a contributing factor in chronic low back pain? Are you tired of hearing from your therapists that they want to address this and then have to justify it to your adjustor?

Look to the article "Conservative Correction of Leg-Length Discrepancies of 10mm or Less for the Relief of Chronic Low Back Pain" from the November 2005 issue of Archives of Physical Medicine and Rehabilitation . The authors' objective was to study conservative correction of LLD of 10mm (1 cm.) or less in patients with chronic low back pain. The participants were randomized, with most patients participating for the full 12 weeks. Of the 33 participants, eleven did not receive correction. The other 22 patients received shoe inserts for correction. The correction started at 2mm and increased every 2 days by 2mm until complete. (The amount adjusted was 10% more than the LLD to compensate for of the insert).

The patients' pain intensity was evaluated using a visual analog scale and a disability score from Roland-Morris Disability Questionnaire. The results revealed that shoe inserts significantly reduced both pain intensity and perceived disability rating. The data also revealed a moderate positive correlation between the LLD and the degree of pain. They concluded that shoe inserts appear to reduce chronic low back pain and functional disability in patients with leg length discrepancies of 10mm or less.

This is important because, traditionally, a LLD of up to ½ inch in many cases has been left uncompensated. Shoe inserts are a simple, noninvasive and inexpensive form of treatment.

Now about that foot pronation…