Back pain from a Lower Limb Length Inequality (LLLI) is a very common phenomenon, but since it is poorly understood medically, it doesn’t get much credence. In my practice I see it all the time. Just this month I’ve seen 5 patients with LLLI in my Neuromuscular Therapy center near Boston. The treatment usually involves an inexpensive and appropriate sized heel lift,  Neuromuscular Therapy for the affected muscles and a home program of Active Isolated Stretching. (I like the Adjust-A-Heel Lift with its peel-off layers and non-slip leather and rubber construction.) To determine the height of the lift, it is best to have a series of three x-rays taken standing erect to determine where the bones are uneven and what the exact difference in height is. Finding a radiology office willing to do this is a challenge. The private radiologist I used retired, so I have resorted to eye-balling it, which usually works well enough to start easing the tension in the muscles. If the asymmetry is more significant, the X-rays and orthopedic shoe corrections may be needed.
Neuromuscular Therapy treatments target primarily the little muscle in the low back called the quadratus lumborum, but more unwinding needs to be done in all the muscles of the hip, buttock, spine and often the thighs and shoulders to mitigate the far-reaching effects of the physical compensation that occurs.
For Teddy O., it took a 5/8″ heel lift, four Neuromuscular Therapy treatments after his evaluation and three instructional sessions on Active Isolated Stretching to get him comfortable. He returned three years later with recurring symptoms and had six Deep Tissue treatments with Trigger Point work with one of our skilled Licensed Massage Therapists. Six years later, his wife says he’s cured!