The effect of leg length on back pain: a classic test
Eight articles on PainSci cite Grundy 1984: 1. The Complete Guide to Trigger Points & Myofascial Pain 2. Does Posture Matter? 3. The Complete Guide to IT Band Syndrome 4. The Complete Guide to Low Back Pain 5. The Not-So-Humble Healer 6. Are Orthotics Worth It? 7. Your Back Is Not Out of Alignment 8. Reading Guide for Professionals
PainSci commentary on Grundy 1984: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
This classic, elegant experiment found no connection between leg length and back pain. Like most of the really good science experiments, it has that MythBusters attitude: “why don’t we just check that assumption?” Researchers measured leg lengths, looking for differences in “lower limb length and other disproportion at or around the sacroiliac joints” and found no association with low back pain. “Chronic back pain is thus unlikely to be part of the short-leg syndrome.” Other studies since have backed this up, but this simple old paper remains a favourite.
~ Paul Ingraham
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
In a case-control study, in which a specially designed questionnaire and a ‘locating jig’ were used to investigate the association between difference in lower limb length and other disproportion at or around the sacroiliac joints and the existence of chronic low back pain, no association was found. Chronic back pain is thus unlikely to be part of the short-leg syndrome.
- “Relationship between mechanical factors and incidence of low back pain,” Nourbakhsh et al, Journal of Orthopaedic & Sports Physical Therapy, 2002.
- “Leg-length discrepancy is associated with low back pain among those who must stand while working,” Rannisto et al, BMC Musculoskeletal Disorders, 2015.
- “Comparison of supine and prone methods of leg length inequality assessment,” Cooperstein et al, J Chiropr Med, 2017.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.