Are you dealing with constant foot pain that just won’t go away? Maybe your hip aches after a long day. Or your back pain just doesn’t get better, no matter what you try? Here’s something your doctors might have missed: it could all be coming from one hidden cause—a leg length discrepancy. In this post, we’ll explain how to determine if the difference in length between your legs is the cause of your pain. Then, we’ll review how to address the issue so you can finally say goodbye to discomfort.
Leg Length Discrepancy: How Common is this Problem? ![two legs of different length]()
While it sounds surprising, about 70% of all people have some discrepancy in the length of their legs. But here’s the key. Not all discrepancies need to be treated. Instead, it’s crucial to understand when the differences in length are causing problems.
How Length Differences Lead to Pain
Think of your body like a chain: when one link is off, it effects everything else. A small difference in length could create a domino effect of problems, causing rolling ankles, hip misalignment, back pain and more. In our Houston podiatry practice, we see many patients who have tried to treat the symptoms individually, without success. And that’s because they never detected or understood the root cause.
There are two types of leg length discrepancies. Understanding which one you have can help you find the right solution. The first is called a structural or anatomical difference. This means the bones in one leg are shorter than the others. This can happen from birth, after an injury, or following a hip or knee replacement.
The second type is a functional difference. This is when your legs are actually the same length but a muscle imbalance, joint problems or even the way you stand results in one leg appearing shorter than the other. Luckily, this type responds very well to treatment. But before we get to treatment options, you’ll need to understand how this condition is detected.
Diagnosing Leg Length Discrepancy in Houston
If we suspect you have either type of discrepancy, we’ll start with a standing evaluation in our Houston podiatry practice. This will check your pelvic alignment, and determine how your body compensates. We’ll also take measurements when you’re lying down, comparing specific anatomical landmarks on each leg.
Sometimes we need to go deeper, with imaging studies. A standing pelvic X-ray can measure the tilt of your pelvis, thereby highlighting the amount of limb length difference. This is particularly important if you’ve hap hip or knee replacement surgery—about 30% of patients experience some degree of leg length discrepancy after undergoing one of these procedures. Now, some degree of discrepancy is normal for about three months after a knee or hip replacement. However, if it persists beyond that period, or causes significant pain, we’ll need to intervene.
Treatment Options
One of the most effective ways to address a leg length discrepancy is by using custom orthotics with incorporated lifts. These aren’t your typical, over-the-counter insoles. Instead, they’re precisely calibrated devices that address both the leg length difference and any underlying foot mechanics that might be contributing to the problem. The process of crafting your orthotics starts with a detailed scan of your feet. We capture your foot structure in its optimal position, then add specific modifications to address the leg length difference and biomechanical issues that may have been detected. Then, the lift component is built directly into the orthotic. This distributes the correction across the entire foot, rather than just the heel, providing more stability and comfort than just a heel lift.
What makes these orthotics extra special is their gradual adjustment capabilities. We often start with a slightly smaller lift than the full thickness required to compensate for the length difference; allowing your body to adapt gradually. Every few weeks we can adjust the lift height until you reach the optimal level, preventing the muscle strain and discomfort that can result from correcting too quickly.
Management and Follow-Up Care
Long-term management is crucial for success. Initially, we typically schedule follow-up visits every three to four months, moving to every six to twelve month visits once we’ve achieved optimal correction. During these visits, we’ll evaluate how your body is adapting. We’ll also check the wear on your orthotics and make any significant adjustments. Finally, we’ll need to review your shoe choices. Since you’ll have to wear orthotics consistently, you’ll need to select footwear with removable insoles and adequate depth. We’ll work with you closely to find choices that accommodate your orthotics while matching your lifestyle and activities.
Prognosis
For most patients, we see significant improvements within the first few weeks of treatment. However, complete adaptation can take three to six months as your body adjusts to its new alignment. During this time, you might need to modify certain activities—runners, for example, might need to temporarily reduce their mileage or incorporate more cross training. But once you’ve adjusted, you should be able to resume all activities—without the pain that led to your original diagnosis!
The success rate with this approach is excellent. Most patients are able to resume full activity within six months of beginning treatment. But consistency is key: wearing your orthotics regularly and following up with the recommended checkups and adjustments will lead to better results.
If you’re experiencing unexplained pain in your hips, your knees or your back, don’t wait to get it checked out. The solution is often simpler than you think. Remember, understanding why you’re in pain is often the first step to finding lasting relief. So reach out to our office today to see if a leg length discrepancy could be the cause of your discomfort!