Low back pain (LBP) is one of the most common complaints presenting to chiropractic offices and remains one of the most challenging conditions to manage because there are so many causes. Some of its causes include the obvious such as over-lifting, over-use activities such as sports injuries (bowling, golfing, skiing, tennis, football, etc.), raking leaves, shoveling snow, and more. Frequently, work-related strains are the primary cause of LBP due to the constant, persistent, and awkward positions frequently required in many jobs.

The cause can also be as simple as standing on two feet vs. four feet. Studies show when two-legged and four-legged animals are compared, arthritis starts in the 3rd vs. the 6th decade of life, respectively, due to the vertical load placed on the biped or two-legged animal. Because we are two-legged species, addressing a short leg can have significant benefits to any spinal condition. This is because a short leg of only 5mm (1/4 inch) can result in a drop in the pelvis that creates a crooked foundation that the spine sits on, leading to an abnormal curvature in the spine. This places stress on the spinal components—including the spinal cord and nerves—and can contribute to or be the actual cause of not only LBP, but also problems higher in the spine including neck pain and headaches!

Many times, a satisfying outcome is not achieved until the leg length issue is addressed with the use of heel or a combination of heel and sole lifts. In one case, treatment to the neck and head had little effect on a patient’s headaches and only after placing a heel lift in one shoe and arch support in both shoes did he report significant improvement.

In most cases, treatment addressing the entire body from the feet up yields the most satisfying results. Also, secondary issues such as diet, stress management, and home treatments (including exercises), can be very important in the successful management of back pain. In many patients, a combination of chiropractic, leg length correction, and nutritional management—including the use of vitamin and herbs—results in the best outcomes.

Usually, offering the patient advice on the methods of applying ice, modifying/reducing bending/ lifting activities, as well as performing the chiropractic treatment will satisfy the majority of patients. However, in some cases, co-management with other allied healthcare providers is necessary, especially where there is a slow response in the initial acute stage of LBP. If these less common cases should occur, the combination of chiropractic and primary care yields the best results.