Short leg and low back pain

Short leg and low back pain has news from Journal of Rheumatology.

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

rheumatologist J. Philip Gofton, MD.

X-ray showing how a short leg can cause a scoliosis.

"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

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 ...

    Short leg and low back pain

    Short leg and low back pain may be effectively treated with a shoe lift according to a leading medical researcher.

    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

    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?

    From Leg Length Inequality and Low Back Pain to More research about the short leg.

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