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.