Uneven Leg Length and Degenerative Joint Disease of the Hips
When traditional Medical Doctors take X-rays, they are primarily concerned with finding broken bones, dislocations, or disease. Chiropractors look for those things too, but we also get valuable information about balance and alignment, some of which was validated by a recent study. Some people grow up with one leg slightly shorter than the other. Common sense would suggest that this would lead to less efficient joint movement and greater wear and tear in the body. 255 adult X-rays were analyzed to measure hip and low back Osteoarthritis in relationship to short leg. There was a significant correlation (though nearly twice as high in men as in women) between degenerated joints in people with short legs compared to those whose leg lengths were balanced. There was also a statistically significant relationship with low back spinal degeneration, though nowhere near as strong as that of hip degeneration.
What I find sad about this is that if leg length discrepancy is properly diagnosed, the main treatment is a rubber heel lift of a specific height placed in the bottom of the shoe on the short side. It provides a functional balance between the hips and we sell them in our office for a whopping seven dollars. Very few remedies in health care come that cheap. Of course, it is essential for the X-rays to be taken standing up in weight bearing, otherwise the relative leg length is meaningless. Using a tape measure to estimate leg length on physical exam has limited reliability, since soft tissue variations can create errors.
This new study only measured the correlation, or general relationship between short leg and hip/lumbar spine degeneration. Proving a cause/effect relationship would be much harder to do, but this study suggests it would be worth it to pursue, even if at the end of the day, a specific heel lift is likely to remain the best treatment.
*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. JMPT, June 2017, Vol 40, Issue 5, p320-329.
-Dr. Russell Petersen, DC. Creekside Chiropractic & Rehabilitation, 4027 S. Business Drive, Sheboygan, Wisconsin.