There are numerous causes of low back pain and sacroiliac pain.  A common cause of such pain is leg length discrepancy – which can be either functional (i.e. resulting from muscular compensation, trauma etc) or structural.  

Often patients with a leg length discrepancy will exhibit excessive pronation.  In the case of structural leg length discrepancy the patient will often present with unilateral pronation (i.e. worse on one foot) as a natural body compensation for the structural imbalance.  Patients with a structural leg length discrepancy will require ICB Orthotics (for both feet) to firstly correct the pronation.  Next an appropriately sized Heel Lift addition should be added to the orthotic on the shorter leg.  By doing so the shorter leg will be raised, thus aiding in rebalancing the lower limb, and removing compensatory mechanisms that are often the cause of lower back and sacroiliac pain.

As in the case of a structural leg length discrepancy, patients exhibiting a functional leg length discrepancy also often experience more pronation on one foot (the longer leg side).  ICB Orthotics treat functional leg length discrepancy by correcting pronation.  A heel lift should NOT be applied to the shorter side.  ICB Orthotics will correct and rebalance the lower limb, whilst mobilisations or adjustments may be required to loosen tight muscles that may be causing pelvic imbalance.

Low back pain can be experienced in combination with excessive bilateral pronation – as the feet pronate and collapse the pelvis rotates anteriorly and an increased lordosis occurs at L1-L5, placing increased stress on the lower back.  Correcting the excessive pronation will assist by posteriorly rotating the pelvis and thus reducing pressure on the sacroiliac area.

Patient’s presenting with a leg length discrepancy often also exhibit Scoliosis.