Tilted pelvis lower back pain and leg length discrepancy

Scott R. Greenberg, MDScott R. Greenberg, MD

As you know, most people in this country will suffer with back pain at some time in their life. In many cases, the pain will resolve on its own in a week or so. But for others, the pain becomes chronic and a life-long journey may take place to alleviate that pain.

I remember as a young adult when my father’s back would “go out”. He would suffer from terrible pain, have muscle spasms, and would not be able to go to work.
I also remember that Dad would not be able to stand straight-he would stand curved like the letter “S”. In performing thousands of Prolotherapy treatments for patients like my father, I began to think back to my youth, and ask why he would be “crooked” as he described.

Stand in the mirror. Put your hands on your hips at exactly the same place on your body. Is one side slightly higher than the other? I would bet it is, as over 95% of the patients who come to my office for treatment of back pain have a tilted pelvis – often diagnosed by Chiropractors and Osteopaths as a leg length difference.

And I know after successfully discovering how Prolotherapy can correct the discrepancy that chiropractic care, physical therapy, massage, acupuncture, orthotics, or surgery does not correct a tilted pelvis or its resultant leg length discrepancy.

Researchers in Israel still find that controversy exists as to the  clinical significance of leg length discrepancy in spite of the fact that further evidence has been emerging regarding the relationship between several clinical conditions and leg length discrepancy. They were able to conclude in their research that

  • A significant relationship was found between anatomic leg length discrepancy and walking problems that would lead to joint breakdown.1

Why is correction of the tilt so important? Our pelvis and lower back was designed to operate on a level plane. Therefore, most of the forces across the low back are linear, and do not damage structures such as the sacroiliac (SI) joint, iliolumbar ligament, Pyriformis, and gluteus medius. However, when the pelvis tilts, the forces that hold the above mentioned structures become shearing, rather than linear. The ligaments, tendons, and joints around the lower back and pelvis suffer and must withstand a greater force than those without a tilted pelvis. If this concept seems difficult to understand, try walking a short distance in your house while only wearing one shoe, and feel the effect on your lower back.

It does not take much to alter body mechanics

In Finland, doctors supported research that suggests that leg-length inequality of 5 mm (about 1/5th of an inch) can be associated with an increased risk of osteoarthritis of the knee and hip. They also found that hip or knee replacement due to is done 3 times more often to the longer leg than to the shorter leg.2

I have developed a Prolotherapy technique to correct this pelvic tilt. I routinely evaluate and treat this problem on the first visit, and find it an integral part of treating anyone with back, knee, neck, hip, or ankle problems. My success rate in immediately correcting the leg length discrepancy and pelvic tilt is over 95%. And the correction is not temporary! It’s probably the most remarkable discovery that I have come across in the application of Prolotherapy.

How does this technique work? I discovered a dysfunctional muscle pathway that travels from the foot up to the hip area. I believe that when this pathway becomes inadvertently and unknowingly damaged, the muscle groups in the leg contract the space between the leg and pelvis, thus tilting the pelvis and shortening the leg. As I mentioned, correction of this muscle problem will immediately restore the normal leg length and place the pelvis back onto a horizontal plane.

I strongly believe this is one of the most important problems to correct in patients with lower back pain, and will help to insure a complete and speedy recovery!

1 Khamis S, Carmeli E. Relationship and Significance of Gait Deviations Associated with Limb Length Discrepancy: A Literature Review. Gait & Posture. 2017 May 31. [Pubmed] [Google Scholar]

2 Tallroth K, Ristolainen L, Manninen M. Is a long leg a risk for hip or knee osteoarthritis? A 29-year follow-up study of 193 individuals. Acta Orthopaedica. 2017 Sep 3;88(5):512-5. [Pubmed] [Google Scholar]

Dr. Greenberg is located at the Magaziner Center Prolotherapy New Jersey.

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