The medical condition called “leg length discrepancy” is more commonly known as “short leg syndrome” or SLS. Simply put, it is a condition where one leg is shorter than the other. The most severe cases can have an impact on the person’s gait and posture, leading to pain and other issues depending on the degree of difference. Having one leg shorter than the other puts additional weight and stress on one side. It throws the body out of balance, resulting in problems with the joints throughout the body. Without treatment, SLS can cause more serious health conditions and pain.
Significant limb length discrepancy is usually easily recognizable. While walking, the affected person might:
- Tilt their shoulders to one side
- Swing arms unequally
- Show a pelvic tilt
- Foot supination (foot rolls outward) on the side of the shorter limb
- Foot pronation (foot rolls inward) on the side of the longer limb
- Plantar flexed ankle (foot points down toward the sole) on the side of the shorter limb
- Knee flexed (flexed knee) on the side of the longer limb
During youth, even significant discrepancies are usually tolerated well. The body employs mechanisms to compensate for the difference in leg length. But once an affected individual gets around 40 years of age, these mechanisms begin to fail.
There are two types of SLS: structural and functional.
Structural SLS refers to the actual shortening of the skeleton due to congenital (at birth), traumatic, or diseased origins. It might occur in childhood due to an injury or an infection. Sometimes the legs don’t grow at the same rate, resulting in one leg growing increasingly longer than the other. In these pediatric cases, doctors might remove part of the bone in the longer leg or retard the growth.
Functional SLS is where one leg becomes shorter due to the mechanics of the lower body. Some examples include conditions where the foot turns outward, or the pelvis is misaligned. Sometimes athletes who run on hard surfaces develop foot problems that lead to functional SLS. A woman who always carries a child on one hip or a man who always sleeps on one side might cause the body to shift.
With functional SLS, the discrepancy in leg length is apparent but not measurable. When the doctor measures the leg bones, they are the same length. To better understand this concept, stand up straight with both arms at your side. Raise your right shoulder and note that your right hand now rests significantly higher on your leg than the left one. You haven’t changed the length of your arm bone, but it appears shorter than the left. In the same way, a rotated pelvis changes the length of your legs, but you can’t choose to restore the balance and improve the symmetry of your lower body.
No one has a right side that is a perfect mirror image of their left. The same ring that fits your ring finger on one hand might not go on the same finger of the other hand. One ear might be smaller and more rolled up than the other. For many people, one shoe fits a lot looser than the other one. It shouldn’t surprise us then that for some people, the length of one leg differs from the length of the other.
As many as 70% of all people have some degree of discrepancy in the length of their legs. For most, the amount is negligible and doesn’t cause any problems. Those with a significant discrepancy are at a greater risk of having back pain and other symptoms. Since those with minimal discrepancies never experience symptoms or realize they have SLS, it is impossible to determine the exact number of people affected.
The prevalence of leg length inequality remains a topic of debate among researchers. People with a difference of less than an inch might not realize the difference in their leg length. It’s also difficult to tell how much of a discrepancy it takes to cause problems. SLS causes changes in a person’s gait. It impacts the way they walk and run. Those changes can lead to knee, hip, back, and pelvic pain. Some researchers also believe SLS puts you at a greater risk for stress fractures and running injuries.
Research also shows that people aged 50 to 79 with more than one-third of an inch difference in leg length were more likely to have osteoarthritis of the knee. Fortunately, treating most people with short leg syndrome is easy.
Doctors use several diagnostic methods to identify SLS. Someone experienced in diagnosing and treating the condition might recognize it in their walking pattern. When it occurs with other contributing conditions like congenital scoliosis, they might identify SLS by the symptoms of the other condition. Scannograms, full-length standing X-rays, aid in measuring the leg length discrepancy as well as measuring spinal curvatures.
The method of treatment depends on whether a person has structural or functional SLS and the degree of discrepancy in length.
Doctors often “treat” structural SLS by placing a heel lift in the shoe of the shorter leg. A physical therapist determines the amount of lift required to restore the positioning of the spine and pelvis. For cases requiring surgical shortening or lengthening of a limb, the surgery must be followed by physical therapy. This helps them stretch their muscles and retain the joint flexibility that is necessary to heal properly.
Doctors treat functional SLS at the root cause using manual therapy techniques and therapeutic exercise for the pelvis and lower extremities. A chiropractor might have you lie on a table and examine them to compare leg lengths.
The primary goal of treatment is to improve alignment and restore symmetry to the lower extremities. A chiropractor who is experienced at diagnosing and treating short leg syndrome can help. They have the knowledge and tools to adjust the spine and realign it to improve balance. Spinal adjustments help the muscles and joints “loosen up” for better healing. Chiropractic care treats SLS at the root of the problem in some functional SLS cases.
In some cases, the chiropractor will recommend the use of orthotic heel lifts in combination with chiropractic treatment. It depends on the severity of the discrepancy. Repeated visits to the chiropractor will provide pain relief and improve mobility in most patients. Chiropractic treatment provides better pain reduction and fewer recurrences in comparison to medical treatment alone.
The spine keeps the body balanced and upright. It also protects the central nervous system. It does its job well when it is properly aligned. It keeps the body balanced and the communication between the brain and body working efficiently. When injuries, illnesses, or other outside forces interfere with the spine’s alignment, it can impact the health of the entire body.
A misalignment is a minor dislocation of a bone. When the misalignment occurs to the spine, the body shifts out of balance. Sometimes it causes pain, but it always leads to degeneration. To some degree, the body can correct misalignments that would otherwise result in long-term damage to the nervous system.
A subluxation is a misalignment that affects the nervous system. Once the misalignment impacts the nerves in the spinal cord, the body no longer can correct the problem. As a result, the person’s health declines. Subluxation leads to a breakdown in the body’s communication. Mistakes can then occur in various systems of the body. Initially, you might notice only small changes. When the problem isn’t treated, those small changes add up over time, resulting in chronic illness.
Manipulations are the use of force to mobilize an entire area. The technique doesn’t isolate a joint or vertebrae. The chiropractor moves his hands over an entire area until a “crack” occurs. A manipulation involves using the same treatment to every person with back pain regardless of the cause. Many experts feel that manipulations provide short-term relief instead of correcting the cause of the person’s pain.
An adjustment is a specific manipulation. It is a type of manual therapy chiropractors use to realign joint subluxations. Since the body is unable to correct subluxations on its own, it requires manual manipulation. This process begins with an assessment by the doctor to pinpoint the location of the subluxation. He then confirms the information with x-rays to determine the best approach to treatment.
Most patients with short leg syndrome approach chiropractors with back pain on one side or the other. Studies have shown that in the majority of cases (75%), the right leg is the shorter one. Although there is an awareness of the right limb dominance, patients don't usually know the reason why.
Once the shorter leg throws the spine out of balance, damage begins. If you don’t have any symptoms, it doesn’t mean that SLS doesn’t have a negative impact on your health. The body compensates for the discrepancy in different ways. For example, you might lean to the side of the shorter leg and put more weight on that side.
One way that chiropractors test patients with SLS is by having them stand on two different scales at once. The side with the shorter limb weighs more. Some chiropractors have weighed patients with a difference of as much as 60 pounds!
After diagnosing and adjusting the patient, the doctor weighs them again. Usually, the body is once again in balance.
Everyone who has short leg syndrome doesn’t experience pain. Those with the greatest discrepancy are more likely to have increasing physical symptoms as the damage builds. Early on, while the body compensates for misalignments, the signs might go unnoticed. Once the condition affects the central nervous system, pain and other symptoms become an issue. The sooner you have your pain diagnosed, the less time your condition has to cause more damage to your body.
Short leg syndrome sounds more frightening than it is. If you’ve never been to a chiropractor, you might not know what to expect. One of the biggest benefits of chiropractic care is that it doesn’t involve invasive treatments like surgery, and it eliminates the need for strong drugs with dangerous side effects.
Chiropractors are health care professionals who focus on the body's ability to heal itself. They specialize in caring for patients with painful conditions in the back, neck, and head. They have extensive training and knowledge of every area of the body and how the various symptoms work together for overall function and good health.
A chiropractor uses gentle pressure to adjust misalignments and subluxations. Usually, there is no pain or discomfort. Often, patients feel immediate relief after treatment. Untreated pain can become chronic. Chiropractic treatment reduces and eliminates pain for many patients, including those that don’t respond to medical treatment. Chiropractors provide drug-free treatment for multiple conditions that cause back pain, including many cases of short leg syndrome.
Approximately 80% of all people will experience back pain during their lifetime. Back pain is a leading cause of missed work days for both men and women. Often, the pain persists even after extensive medical treatment and even surgery.
Considering the large portion of people who experience short leg syndrome, a significant portion of that number will include those with SLS. Any time the spine is thrown out of balance, it has an impact on the rest of the body, leading to various types and degrees of pain. One of the most common symptoms associated with SLS is back pain. Chiropractic treatment offers pain relief for the back and other affected areas of the body without the risks associated with drugs and surgery.
If you think you might have short leg syndrome or you’re experiencing unexplained pain, contact True Spine Chiropractic today. Schedule an initial consultation to learn more about upper cervical alignment and your options for treatment. During your first visit, we’ll gather information about your symptoms, take measurements, do an exam, perform upper cervical x-rays, and perform a detailed history to determine the best course of care for you.
If you are experiencing lower left back pain, you may be trying to figure out what’s causing it and how to make it go away. Here’s the lowdown on what can cause that kind of pain, how it’s typically diagnosed, and what your treatment options are, including chiropractic care.
If you are experiencing extreme back pain with any of the following symptoms or circumstances, you should think about visiting an urgent care facility or the emergency room to be safe:
Lower left back pain can be caused by both internal and external factors. Let’s look at both, so you have a better understanding of what might be precipitating your pain. Keep in mind that in some cases, lower left back pain can be caused by more than one thing, such as a sports injury exacerbated by driving or poor work ergonomics.
Exercise can sometimes cause lower left back pain if you overuse or crunch the left side of the body, which is common in sports that favor one side over another. This is especially true if there is bending and twisting involved (see below). Sports that are “sided” include:
Exercise-related muscle pain is typically seen when you resume exercise after time off, try a new sport, or up your training level in an existing sport. Weekend warriors who sit in an office all day and only play sports on their days off are particularly susceptible.
Often exercise pain is related to inflammation or straining of muscle or soft tissue, however it is possible that it can also involve spinal column damage (see below).
Bending and Twisting
It’s not only sports that can cause bending and twisting-related lower left back pain. Working in the yard or garden, doing strenuous household chores, lifting small children, and repetitive labor can all cause back problems when done to excess or without proper form (e.g., using the large muscles of the thigh and the abdominals when lifting).
Lower back pain that results from bending and twisting can come on suddenly, such as when you lift something much heavier than normal, or it can develop gradually after a day or more of strain. Like exercise-related pain, this can involve soft tissue only, or it can include spinal column damage.
Fall or Trauma
A fall or trauma to your back, such as getting hit with a baseball, can easily cause lower left back pain if you strike your back in the process. These kinds of injuries are seen in sports as well as around the home and at work, including falls on the stairs, in the tub, and on icy sidewalks.
Usually, you know what caused back pain in this type of injury. However, be aware that you don’t even need to fall in some circumstances to hurt your back; if you start to slip, you may brace yourself trying to prevent a fall and hurt yourself that way.
Lower left back pain can result from driving, whether you drive a bit too much every day or simply take one long drive, such as for vacation. People who drive as part of their jobs, like delivery and salespeople, are particularly prone to driving-related back problems, as are people who drive in stop-and-go traffic with a manual transmission that requires a lot of time on the clutch.
Lower left back pain from driving can involve the sciatic nerve that runs from the lower back all the way down each leg. Therefore, the pain may also be felt in the buttocks, the legs, and the outside of the ankle.
Poor Work Ergonomics
Pain from poor work ergonomics is often symmetrical, but it can be focused on the lower left back if you favor one side more than another. This can include:
This type of back pain typically comes on gradually, but you may see it appear suddenly if something changes in your work environment or duties.
Sleeping in the Wrong Position
Have you ever awakened after a deep sleep to find your back or neck hurts? Sleeping in the wrong position can definitely cause lower left back pain, especially if you maintain that position for hours on end or fall asleep outside your bed, such as on a sofa or chair. Having the wrong sleeping surface may contribute to this type of back pain as well.
Spinal Column Damage
You can have damage to your spinal column that can cause lower left back pain too. Sometimes this damage is related to one of the issues listed above, while in other instances it exists on its own. Three of the most common types of spinal column damage that cause lower back pain include:
Although sometimes you may suddenly have lower back pain from spinal column damage, this is normally less of an acute condition and more one that comes on slowly over time.
Bowel Disease or Impaction
Chronic bowel disease, most often ulcerative colitis, as well as impaction of the bowel can precipitate lower left back pain. When the colon (large intestine) is involved, this part of the back may also hurt. While bowel impaction involves severe constipation because nothing is moving through the colon, ulcerative colitis usually involves back pain plus these symptoms:
Pregnancy can cause lower back pain, especially as the fetus grows and pulls on the mother’s body. The position of the baby can also cause pain, as tiny hands and feet or the head of the baby press on the back of the uterus. Poor core strength, overexertion, unsupportive footwear, and standing for long periods can provoke or exacerbate lower left back pain. When contractions start before delivery, back pain can also occur.
Multiple gynecological conditions can cause lower left back pain. In addition to menstruation and ovulation, which can cause predictable and transient lower back pain, fibroids and endometriosis can also cause lower left side pain.
Endometriosis is when excess uterine tissue grows outside the uterus. This usually involves abdominal pain, painful menstrual cycles, and fatigue. Fibroids are benign lesions growing inside the uterus that also cause frequent urination, painful intercourse, and abnormal menstruation.
Your kidneys are located in the right and left flank area, towards the back of your body. Kidney infections start elsewhere in the urinary system, such as in the bladder, and progress to the kidneys, usually when left untreated or inadequately treated with antibiotics. Other symptoms of a kidney infection besides back pain include:
Kidney stones form when the urine can’t dilute crystal-forming elements like calcium fast enough or when the urine isn’t able to prevent crystals from joining to form larger stones. Pain from a kidney stone may be caused by a stone moving inside a kidney or when a stone travels through a ureter, the tube that connects your bladder to your kidney on each side.
Kidney stones can cause terrible lower left back pain, as well as painful urination, inability to urinate, nausea, vomiting, and blood in the urine. If you can actually see blood in your urine, that is known as gross or macroscopic hematuria. You can also have blood in your urine that cannot be seen with the naked eye, AKA microscopic hematuria.
Your pancreas produces insulin to regulate sugars in your bloodstream, and it also makes digestive enzymes to break down food. Pancreatitis can be caused by numerous factors, including certain medications, like lactase for lactose intolerance. It is characterized by dull back pain in the lower left side that often gets worse with eating, especially after consuming high-fat foods.
The diagnosis of back pain begins with a questionnaire about the patient’s activities, lifestyle, and medical conditions. As you can see from the list above, multiple factors can cause lower left back pain, so your physician or chiropractor will try to narrow down what could be factors in your situation.
Because chiropractors specialize in the treatment of the back problems, they are often skilled at asking the right questions to get started on the right path. Typical questions include:
A physical exam is also important. A chiropractor or other practitioner will want to palpate (touch) the area to see if it provokes the pain and where the pain is located. They will want to see if it limits other mobility. They may want to check your vital signs or check for concurrent pain elsewhere, like in your abdomen.
Sometimes medical imaging is also necessary to see what’s going on inside the body. This can include x-rays (radiographs), ultrasound, or a CT scan, many of which are used by both chiropractors and medical doctors these days. Blood tests may be necessary as well, such as in cases of suspected pancreatitis.
Fortunately, there are many non-invasive treatment options available today, and only rarely is surgery necessary for pain in the lower back. Treatment is based on the practitioner’s diagnosis and may include any of the following:
Have you been suffering from lower left back pain? Don’t let pain become a habit or rule your life. Contact True Spine Chiropractic today. We are here to help get to the bottom of your back pain, so we can treat it and let you get back to living life at its fullest!
If you’re suffering from back pain, you may not realize that dehydration could be causing it. What a lot of people don't know is that dehydration and back pain can actually be related. Let’s take a look at what exactly happens in your body when you’re dehydrated and how you can avoid dehydration-related back pain.
Dehydration is the state of not having enough water in the body. When your body uses and excretes more fluid than it takes in, you can become dehydrated.
Anyone can become dehydrated. However, as you read more below, you’ll see why dehydration is more common in certain groups. Children and the elderly are particularly prone to dehydration.
While dehydration can happen to anyone who doesn’t drink enough water, there are causes that speed up dehydration or factors that make people predisposed to it.
Infants and young children, as well as older adults, have a lower volume of water in the body. This means that any additional causes of dehydration, such as those listed below, can propel them into dehydration quickly. Also, these polar ends of the age spectrum may have difficulty recognizing when they need to drink water and being able to act on that need.
Vomiting and Diarrhea
Gastric upset, namely vomiting and diarrhea, is a common way to become dehydrated. Having a sick stomach doesn’t just flush water out of the system; your body also loses electrolytes. Electrolytes are minerals present in the body that help it function on a cellular level. Loss of electrolytes can result in cramps, confusion, and even death if severe enough.
A fever can cause excess sweating, which can cause dehydration (see below). It can also make you less likely to eat and drink to replenish fluids naturally.
Sweating can easily cause dehydration, as you’ve probably experienced after a good workout. Not only do you lose water when you sweat, but you lose electrolytes too. You may have felt salt on your skin after a heavy sweat.
You don’t have to be exercising to sweat to the point of dehydration. Hot weather, overdressing, menopause, and certain medical conditions can also cause sweating. People who work outside, especially in strenuous jobs, are at risk for dehydration too.
Climate and Geography
If you live in a dry climate, you may find yourself more easily dehydrated as the air naturally pulls water from everything around it. Living at a higher altitude can also make you dehydrated more quickly because it causes you to breathe faster. Rapid breathing increases urination, which flushes out fluids more rapidly.
Diabetes and Certain Medical Conditions
People with diabetes often have difficulty managing their fluid balance. They may have kidney disease as well, which further predisposes them to dehydration. There are numerous medical conditions, like irritable bowel syndrome (IBS), that also cause dehydration.
Heavy menstrual periods mean greater blood loss for women. Since a high volume of blood is composed of water, this can result in monthly dehydration.
Pregnancy and Breastfeeding
Both pregnancy and breastfeeding put an increased demand on the body for water. Women who are expecting or lactating need to consume extra water just to maintain their baseline requirements.
Medications and Supplements
Some medications and over-the-counter supplements may cause dehydration. In addition to diuretics and laxatives, which you would expect to cause fluid loss, drugs like antihistamines, blood pressure medications, and antidepressants can precipitate dehydration. Dandelion and watercress supplements are two examples of natural supplements that increase urination and can, therefore, cause dehydration.
Carbohydrates help the body hold onto water. If you are on a low-carb diet, you need to consume extra water because you’ll be urinating much more frequently.
Drinking Caffeine and Alcohol
Your body needs water to process alcohol and caffeine internally. If you drink caffeinated or alcoholic beverages, try alternating them with one large glass of water.
Your adrenal glands work overtime when you’re stressed out. If your adrenals become too taxed, they can stop producing aldosterone, which helps the body manage your fluid and electrolyte levels.
Surprisingly, thirst is not the first symptom of dehydration. By the time you’re thirsty, you may already be low on fluid. Of course, infants and young children can’t always tell you when they are thirsty or don’t feel well. It’s important to know the signs and symptoms of dehydration for people of all ages:
Your urine should normally be the color of light straw--a pale yellow-green color. The darker your urine, the more dehydrated you are. Checking your urine is one of the easiest and most reliable ways to see if you’re dehydrated.
If not corrected, dehydration can produce serious complications and eventually lead to death. The following are the most common complications of dehydration:
Another symptom of dehydration is back pain. You read above that dehydration can cause joint pain, and that includes the joints of the spine.
The vertebrae in your spine are cushioned with discs, little fluid-filled, jelly-like sacs that act like the suspension in your car to absorb shock and help the vertebrae move freely. Think of them as both support and protection for your spine.
Those discs are nearly three-fourths liquid. The fluid in your discs comes from the water you drink, so it’s no wonder that if you become dehydrated, your spine can suffer.
Your spinal discs shrink anyway during the course of the day, with your body replenishing their liquid at night. But if you’re dehydrated, it’s a double whammy your body has to compensate for while you sleep. And until you rehydrate, you may experience back pain of varying degrees commensurate with your fluid loss.
When the discs in your back become really dehydrated, they can bulge and cause even more pain. Walking, performing exercise, or doing the simplest chores can cause terrible discomfort. Therefore, it’s vital to stay hydrated for optimum spinal health.
While it’s obviously wise to stay hydrated for the function of your spine, there are so many other benefits to drinking enough water.
Your skin soaks up water from the inside like a sponge, and of course, it’s the body’s largest organ. When you stay hydrated, you see the results almost right away, in plumper, rosier skin that heals from wounds faster and protects the body better from cold.
Because all the cells in your entire body rely on water, when you’re hydrated, it’s like an engine that’s just been tuned up with all the right fluids. Often, when we feel fatigued and think about eating something sugary, what we really need is water. Try drinking a glass of water first before indulging in that sweet and you may find most of the time you don’t even want it once you’re not thirsty.
Better Sports Performance
As well as fueling all the cells for your muscles, connective tissue, and nerves, water helps your body produce natural synovial fluid, a lubricant for your joints. Without adequate hydration, you may find your joints creak and your body feels years older than it actually is. Don’t forget too that your blood is largely water, so to keep your cardiovascular system pumping, water is essential.
In order to flush toxins from your body, your liver, kidneys, and the skin need water. When you stay hydrated, you help your body remove waste more efficiently so it doesn’t accumulate or remain in the bloodstream.
Water fills you up and keeps you from overeating if you time your drinks right. Drink a glass of water before meals to help manage portion size and substitute water for alcohol to cut back on eating due to the lack of inhibition you feel when under the influence.
Water helps your body process nutrients in your intestines so you get more of the good stuff out of your diet. Also, it aids with motility to keep food moving through your digestive system and therefore prevents constipation.
Your brain needs water too! Make sure to drink enough water to fend off foggy thinking.
Resistance to Illness
When you get dehydrated, your mucosal secretions become dried out like glue. But you need that mucus to fight germs so you don’t get sick. If you blow your nose and yellow stuff comes out, it doesn’t always mean you have an infection; it could be you’re just severely dehydrated.
It’s easy to stay properly hydrated if you give it a little effort, and it’s well worth it in the long run. Here are some tips to stay adequately quenched so your body runs smoothly and you avoid problems like dehydration-induced back pain.
If you have back pain that comes and goes without any apparent cause, you might want to try drinking more water to see if that helps. You may find that once your discs are hydrated, your back pain disappears. If you try improving your hydration for a week or so with no improvement, it may be time to call the chiropractor to look for other causes of your back pain. At True Spine Chiropractic, we can do a thorough examination and help you improve the health of your back. Let us know how we can assist you today.