Leg-length discrepancy is associated with low back pain among those who must stand while working

Abstract

BackgroundSome studies suggest that leg length discrepancy (LLD) is associated with low back pain (LBP) but many have not found such an association leading to conflicting evidence on the role of LLD in LBP.MethodsThe study population consisted of meat cutters with a standing job and customer service workers with a sedentary job from Atria Suomi Ltd (Nurmo, Finland) who were at least 35 years old and had been working in their jobs for at least 10 years. Leg length of each participant was measured with a laser range meter fixed in a rod, which was holding the scanning head of the ultrasound apparatus. Association of the intensity of LBP (10-cm Visual Analog Scale) with LLD was analysed by linear regression model, while the hurdle model was used in analysing the association of number of days with LBP and days on sick leave during the past year. Associations were adjusted by gender, age, BMI, smoking, depressive feelings and type of work (standing or sedentary job).ResultsThe final study population consisted of 114 meat cutters (26 females and 88 males) and 34 customer service workers (30 females and four males). Forty-nine percent of the meat cutters and 44% of the customer service workers had LLD of at least 6 mm, while 16% and 15%, respectively, had LLD of at least 11 mm. In the whole study population, LLD of 6 mm or more was associated with higher intensity of LBP and number of days with LBP. In the stratified analysis, both intensity of LBP and number of days of LBP were associated with LLD among meat cutters but not among customer service workers. The sick leaves during past year were slightly longer among those with LLD 10 mm or more, but the differences were not statistically significant.ConclusionsLLD, measured with a laser range meter, was associated with intensity of LBP and self-reported days with LBP during the past year among meat cutters engaged in standing work.Trial registrationISRCTN11898558 - The role of leg length discrepancy in low back pain.

Comparison of the Leg-Length Change between Opening- and Closing-Wedge High Tibial Osteotomy: A Systematic Review and Meta-Analysis

“…However, several articles have reported concerns that a leg-length discrepancy of 5 to 10 mm is associated with lower back pain and gait abnormalities. [10][11][12][13] Therefore, the magnitude of leglength change after OW HTO was sufficiently large to cause clinical symptoms such as lower back pain and gait abnormalities, whereas it was negligible after CW HTO. OW and CW HTOs are most widely used for treating medial compartmental osteoarthritis of the knee with varus deformity, and each method has its own advantages and disadvantages.…”

“…There have also been concerns about complications such as lower back pain and gait abnormalities related to a leg-length discrepancy of >5 mm. 10,11 Rannisto et al 11 reported that patients with leg-length discrepancies >6 mm presented with more severe and frequent lower back pain than patients with no leg-length discrepancies. Bae et al 6 reported that 57% (17 of 30) of patients showed a >6-mm change in leg length after OW HTO, whereas none showed such a change after CW HTO.…”

Medial opening-wedge high tibial osteotomy affects leg length whereas a lateral closing-wedge osteotomy does not: a systematic review

“…In addition, if a pre-existing asymptomatic leg length discrepancy is present, even a small change may lead to symptomatic complications. Rannisto et al 25 reported that patients who must stand while working and who had leg length discrepancies of >6 mm presented with a higher degree of lower back pain and more days with lower back pain than patients with no leg length discrepancies. In addition, Walsh et al 26 performed a gait analysis study and reported that various compensatory mechanisms, such as pelvic obliquity or flexion of the knee of the longer leg, occurred in patients who had >10 mm discrepancy in leg length.…”

Leg Length Discrepancy in College Students and Its Association with Low Back Pain: a Preliminary Study

“…Th e results showed no association between injury and LLD. Th e association between LBP and LLD was confi rmed by Rannisto et al (2015) involving meat cutters and service workers on their study. Th e results showed LBP was obviously correlated with LLD.…”