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May 4th 2022

How Chiropractic Care Affects Leg Length Inequality and Improves Lower Back Pain

For the vast majority of people, there tends to be one side of the body that is worse than the other. These one sided imbalances or problems are often caused by biased habits (always lifting with your right hand or kicking with your left leg) or exist as compensatory patterns for dysfunctions lower down in the back or pelvis. This is why it’s so important to check the whole spine whenever we assess anyone, careless of where the pain is.

As a result, one of the common findings we see as Chiropractors is a difference in leg length. In fact, there is almost always a tiny disparity in the size and length of a person’s hands, feet, arms, and legs anyway. Think about it, a ring may fit on one hand but be tight on the other, a shoe may feel loose on one foot but be comfortably worn on the other. Most of the time these slight discrepancies in size are normal and have no bearing on an individual’s well-being.

Leg length inequality, unfortunately, is the exception.

According to the American Chiropractic Association, a study found that 75% of subjects who suffered from lower back pain, had legs that were slightly different lengths (5 millimetres or more). The symptoms can be quite severe, depending on the degree of difference in the leg length.

The premise of this problem is that the leg length inequality disrupts the body’s entire balance and symmetry, possibly resulting in issues in the knees, hips, back, shoulders and even up into the neck. The spinal column is designed to bear weight evenly, and, when one leg is shorter than the other, this places additional weight and stress on one side.

Unfortunately, the condition often brings about recurring and sometimes intense spells of lower back pain and mobility issues for the patient. The good news is that once it’s discovered, the patient who commits to consistent treatment measures can manage the condition and resulting lower back pain.

The importance understanding and treating it really comes down to the extent of the difference in length and the cause of it.

Did you know, there are 2 types of leg length inequality?

Just because your leg is short, it doesn’t actually mean your leg is short.

Our pelvis is made up of 3 bones; 2 Ilia (the wings on the side) and the sacrum (which is the triangular bone in the middle), around which the ilia rotate. Because our hip joints are located at the front of our pelvis, if and when our pelvis rotates (either forwards or backwards), it causes are legs to change their length; longer if the pelvis rotates forwards and shorter if the pelvis rotates backwards.

Short legs are therefore most commonly caused by a rotation in the pelvis, which we term a functional leg length inequality – meaning it’s only temporary and can be corrected. Muscular imbalance, over pronation of the foot and even sitting on a wallet or wearing a purse only on one side too long can all be causes for functional discrepancies.

Sometimes however, leg length discrepancies are caused by a past history of fractures, hip/knee/ankle replacements or surgeries or the individual leg bones grew at different rates or durations to each other. This means that there is a measurable difference between the two legs and therefore becomes what’s known as a structural (anatomical) leg length discrepancy.

A structural leg length difference is (in my 10+ years of clinical experience) the most common cause of scoliosis. It often appears during puberty as teens go through growth spurt after growth spurt, and is exactly the reason we always recommend getting children checked early so that it can be monitored before they reach bone maturity.

You can imagine that the larger the discrepancy is and longer the leg length goes undetected, the more the body will need to compensate and the more potential for chronic pain.

But what can be done about it?

The best way to differentiate between a functional and anatomical leg length discrepancy is via careful clinical examination of the hips, spine, and pelvis as well as X-Rays of the pelvis (where a structural leg length discrepancy is suspected).

Chiropractic Care:


Visiting an experienced chiropractor and mapping out a care plan for lower back pain caused by imbalance and differing leg lengths is the best first step. Leg length inequality results in pain because it puts excess pressure and weight on one side of the body. Over time, this creates misalignment in the spine leading to tight/weak muscles and restricted/immobile joints.


Chiropractic adjustments re-align the spine, reintroducing normal movement to the joints, relaxing surrounding muscles and promoting healing in the tissues. Blocks (wedge shaped foam pieces) or “drops” (the clunking bench mechanism that you might have felt when visiting a chiropractor) move the ilia of the pelvis back to their neutral position and therefore decrease/increase the length of the leg as required.

Orthotic Heel Lifts


Chiropractic care does wonders for helping individuals regain their spinal alignment and ease the restrictions in the joints and muscles affected by leg length inequality. But what about changing the structure of the leg?

Naturally, as magic as we chiropractors are, we can’t wave a wand and make a leg grow longer (otherwise I would definitely be taller than I am).

In the case of structural discrepancies, we use orthotics with a heel lift. This is required to balance out the leg lengths, which in turn balances the hips and pelvis. Orthotics can be very effective IF fitted and used properly.

Orthotics also equalise the weight distribution during walking, standing and activities,  helping to reduce symptoms and any resulting pain. Chiropractic care and orthotics gain great advantages over correcting leg length imbalances, and, when used together consistently, offer less pain and fewer recurrences.

For individuals who suffer from recurring lower back pain, a visit to the chiropractor should be the first stop. If leg length inequality is the cause, you can rest assured that it is manageable and even correctable in most cases.

Mark Fairclough

Principal Chiropractor