Date
22 July 2018
If the length difference between the left and right leg exceeds 1cm, orthopedic shoes with special footbeds are recommended. Photo: Reuters
If the length difference between the left and right leg exceeds 1cm, orthopedic shoes with special footbeds are recommended. Photo: Reuters

Leg length discrepancy can cause back pain

Leg length discrepancy (LLD), defined as a condition in which the two limbs have a noticeably unequal length, can be diagnosed through careful observation.

Check from the back if the shoulders, hips, and hems of the pants are on the same level while standing.

Notice if one side or certain areas of the heels are worn off more quickly than the other. And if the body tilts to either side while walking, and one leg is weaker than the other, or the individual often falls to the ground easily, there is a high chance of LLD.

Features of human bodies are not created to be symmetrical. In fact, the left and right legs are not totally equal in length. There are two classifications of LLD: the functional type and the structural type (sometimes referred to as “true”).

The latter type is referred to measurable skeletal differences in the shape and length of the leg bones caused by deformities at birth or bone fractures. Shortening of one side of the fibula, tibia, femur or pelvis could also result from a car accident or bone fractures after full recovery.

A slight length difference between the left and right leg is a very common sight. Anything less than 1 centimeter is considered acceptable. However, if the difference exceeds 1cm, orthopedic shoes with special footbeds are recommended.

Children with the structural type of LLD can wait before implementing corrective measures like using shoelifts, as their bones are still stimulated to grow, unless it leads to more serious health issues like scoliosis.

A discrepancy of more than 2cm can lead to claudication, scoliosis, and discomfort around the knees and ankle joints. Patients who suffer from serious pain should consider bone lengthening surgery.

There is no measurement difference among the functional type of LLD patients. One thing in common is their poor postures, like putting their leg on the knee, sitting in a cross-legged position or standing on either foot.

Waiters or salespersons who need to stand for long working hours have a higher risk of a misaligned spine. People who sit a lot are likely to develop tight muscles around the waist which may lead to anterior pelvic tilt.

If the patient has scoliosis as well, symptoms of a functional type of LLD will be more obvious. Such problems cannot be corrected by simply placing a shoe bed. Instead, manipulative therapy should be implemented to relieve tense muscles or dislocation of the spine and pelvis.

Physical training that builds muscle strength over the entire body is corrective too. Patients should do hip balancing exercises like yoga, swimming, and Tai Chi regularly to correct their poor postures.

This article appeared in the Hong Kong Economic Journal on Feb 13

Translation by John Chui

[Chinese version 中文版]

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licensed chiropractor and physiotherapist

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