Persistent Lower Back Pain Could Be Coming From Your Legs 2021

Lower back pain is a major problem throughout the world, with the highest prevalence among female individuals and those aged 40-80 years old (D. Hoy et. al 2012). The global number is expected to increase over the next few decades as the population ages.

If you are unfortunate enough to be one of the large percentages of the population experiencing lower back pain then you will know that it can really have a negative influence your work and lifestyle.

Your doctor may take an MRI or an X-ray and diagnose you as having a problem with your disc which lies between the vertebrae or perhaps a nerve compression. There are a few diagnoses that can be made and just as many treatments can be offered. This leads to what we call revolving door practice. The patient comes in for treatment and leaves feeling better only to show up again to repeat the whole process. This happens with surgical and non-surgical treatments. WHY?

The answer to that lies in the link between the lower limbs and your spine. For treatments to be effective we need to find the root cause of the problem. Just knowing what’s wrong is not enough. We must answer why did the problem occur. We say this because the diagnosis that you are given is the manifestation of the root cause.

What could the root cause of persistent lower back pain be?

Let’s consider Angela’s (fictional character) case study. She goes to work Monday to Friday where she spends an average of 3 hours in total standing and walking. The rest of the time she is seated. For 2 years now she has had this dull lower back pain and goes for a massage to relieve the back and the tight leg muscles on her left side once a week. She noticed that it was always worse after a day of shopping having walked for hours.

She eventually mentioned it to her general practitioner who gave her an anti-inflammatory drug. It felt good but as soon as she stopped the drugs the irritating pain returned. She then turned to chiropractic which helped. An orthopedic surgeon referred her to their physiotherapy department and that helped too, but the discomfort returned as soon as she would stop treatment.

One day her aunt jokingly said to her: “Why do you walk with your feet turning out like that?” Her aunt later insisted that she should see someone who deals with body alignment problems. It was on this visit where we discovered not just the diagnosis but most importantly the root of the problem. Angela had a leg length difference, that is to say, one leg was shorter than the other by 8mm!

This made Angela’s pelvis tilt (as shown in the picture above) causing the spine to curve. Biomechanical data proves that any difference greater than 3mm can wreak havoc with your alignment and course persistent lower back pain. After addressing the difference with custom made orthotics and proper footwear, the lower back pain and its associated leg discomfort resolved within 3 weeks.

The Biomechanical Examination

There are many other biomechanical anomalies such as flat feet, incorrect leg bone rotational alignment, knee position, pelvis rotation and weakened buttock muscles that can be the underlying cause. It can be discovered by having a biomechanical examination. 

A typical biomechanical examination can lasts 30 minutes and may include X-rays and video gait analyses, and or advanced foot pressure scanning techniques depending on the problem. Expect to have your walking and alignment scrutinized. Treatment may be as simple as wearing custom made insoles inside your shoes or having part of your shoe modified. Many sufferers are pleased to see just how effective this treatment can be.

Lower limb alignment is not the only thing that causes back pain, but it is certainly the most commonly overlooked problem. If you suspect that you may have a leg length difference, book an appointment to see us today!

Written by Mark B. Reyneker
Written by Mark B. Reyneker

Podiatrist 20 years of clinical experience. Practiced in South Africa, Malaysia, and Singapore. Pioneered CAD/CAM custom made orthotics in S.E Asia.

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