Back Pain and Different Leg Lengths

It’s not uncommon for people to assume the human body is perfectly symmetrical, however that is not always the case. Typically, minor differences such as one ear placed a bit lower than the other, or middle fingers that are slightly different in length do not cause any health issues. However, even minor discrepancies in leg length can cause physical challenges since a person’s legs are the extremities that bear the brunt of impact during physical movement. If you are having unexplained hip, leg, or back pain, it could be stemming from a difference in leg length.

Back, Hip, and Leg Anatomy

The impact of a single step involves multiple body parts — starting at the foot, traveling all the way up each leg, radiating throughout the hip area, even affecting the lower spinal area where both hips attach to the spinal column. If one leg is shorter than the other, undue pressure is placed on some of these areas, whereas other areas may weaken over time from lack of normal use. Specifically, discrepancies in leg length can cause issues with bones such as the lumbar (lower back) vertebrae, the sacrum located at the base of the spine, in addition to the pelvic innominate (hip bones). Key muscles throughout the lower back, hip, and leg area may become over or under-used. Some of the affected muscles include the pelvic floor muscles, leg muscles such as the quads and hamstrings, along with core/hip muscles such as the abdominals, obliques, paraspinals, and deep and superficial hip muscles.

Who is Vulnerable?

Some people are born with a congenital malformation where a discrepancy in leg length is noticeable at birth. Others may be born with a difference in length not necessarily significant enough to be noticeable to the naked eye, but enough to cause issues later in life, especially during the aging process. Some people may notice a difference in leg length after surgery, such as a hip replacement, or a repair from a leg fracture or broken bone. Some people may have a primary health issue in and around the back, hip, or leg area, causing them to hold their body in such a way that the muscles on one side of their body tighten to the point where it causes a physical difference in leg length.


Individuals with different leg lengths may experience a host of physical aches and pains throughout the hip and leg area. Some people may have one leg that always seems to have tight muscles, especially the hamstrings. A person may also experience groin pain, buttock pain, SI (sacroiliac) joint pain, and/or lower back pain. Sometimes a person will feel lop-sided as they attempt to walk or perform some other physical movement. Often a person with a discrepancy in leg length will notice greater difficulty with transitional movements such as going from sitting to a standing position.

Physical Therapy Solutions

Professional physical therapy sessions can do quite a bit for patients experiencing seemingly unexplained leg, hip, or back pain. First, they can evaluate a patient’s legs to determine if length differences could be a significant contributing factor to their pain level. If a patient has an underlying issue that causes them to overuse one of their legs, a physical therapist can address the underlying issue, thus freeing the affected leg from excessive use. After identifying the root cause of any length discrepancy, a professional physical therapist can help improve stability and alignment by creating a series of exercises designed to stretch and strengthen key muscles. A physical therapist may also be able to recommend orthotic devices such as shoe inserts or specially-made shoes that will help minimize any difference in a patient’s lower extremities.

If you would like to know more about how physical therapy can help with back, hip, and leg issues, please contact Cawley Rehab at 570-208-2787 or email us at: