Leg length discrepancy | Can Prolotherapy level a pelvis?

Leg-length discrepancy causing hip and back pain

Ross Hauser, MD

In this article Ross Hauser, MD examines the problems of leg length discrepancy and its role in back and hip pain, and in walking difficulties. Also how these problems can be addressed with Prolotherapy. Leg length discrepancy can be a significant problem of joint instability and degenerative joint disease.

See our main page, Prolotherapy for hip pain to learn more about our regenerative treatments for hip instability.

The hip joint joins the leg to the pelvis. Unfortunately for most people, both legs are not exactly the same. They may look the same, but from a biomechanical standpoint, they are not the same. One leg may be rotated either in or out, or one leg may be shorter than the other. The latter is especially common if one leg was broken during childhood. Because the hip joint connects the leg to the pelvis, the hip joint will sustain the brunt of any biomechanical abnormality that may occur.

Leg length discrepancy and degenerative joint forces straining the hip.

This seemingly obvious connection between leg length discrepancy, walking problems and hip and back pain is still a controversial subject.

In new research, doctors in Israel published findings in the medical journal Gait and Posture that sought to determine if there is a relationship between the magnitude of leg length discrepancy and the presence of gait deviations.

Unstable, unbalanced, and high risk for injury. As the discrepancy increases, there is more pain and more instability. 

Even a small deviation in leg length could impact joint stability and degenerative joint disease

University researchers in Australia and Spain combined to publish research in Journal of manipulative and physiological therapeutics that evaluated the correlation between mild leg length discrepancy and degenerative joint disease or osteoarthritis.

They looked at 235 adults, (121 women and 134 men) who went to the chiropractor for back pain. The researchers found a strong connection between leg length discrepancy and degenerative disc disease at the L5-s1 spinal segment and the L4-L5 spinal segment.

The researchers concluded that patients with hip and lower back pain should be evaluated for leg length discrepancy.(2)

In Finland, doctors writing in the medical journal Acta Orthopaedica went back 29 years to show how different leg lengths affected patients over this near 30 year period.

With leg-length discrepancy, either hip joint can cause pain and usually both hip joints hurt to some degree.

With leg-length discrepancy, either hip joint can cause pain and usually both hip joints hurt to some degree. To propel the leg forward, the hip joint must be raised which strains the gluteus medius muscle and connective tendons and the posterior hip ligaments. Leg-length problems are also associated with recurrent lower back problems because they cause the pelvis to be asymmetric.

Whether it is a low back problem, pubis problem, pelvic floor, or hip problem, leg length discrepancy can cause significant and disabling problems down the road.

Prolotherapy to the sacroiliac and hip joints will correct the asymmetries in the majority of cases. The leg-length discrepancy disappears as a result of the leveling of the pelvis. Often a shoe insert or heel lift will be added to help correct the problem.

 

Do you have a question? You can get help and information from our Caring Medical staff

1. Murray KJ, Molyneux T, Le Grande MR, Mendez AC, Fuss FK, Azari MF. Association of Mild Leg Length Discrepancy and Degenerative Changes in the Hip Joint and Lumbar Spine. Journal of Manipulative and Physiological Therapeutics. 2017 Jun 30;40(5):320-9. [Google Scholar]

2. Khamis S, Carmeli E. Relationship and Significance of Gait Deviations Associated with Limb Length Discrepancy: A Literature Review. Gait & Posture. 2017 May 31. [Google Scholar]

3. Tallroth K, Ristolainen L, Manninen M. Is a long leg a risk for hip or knee osteoarthritis? A 29-year follow-up study of 193 individuals. Acta Orthopaedica. 2017 Sep 3;88(5):512-5. [Google Scholar]

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