Question
I have a leg length discrepancy of 11mm that has been contributing to a case of piriformis syndrome that I have had for over a year now. I have been seeing a chiropractor for 7 months and he gave me a 7mm heel lift and has been adjusting my back and pelvis. Over the past month, I have been having back pain, mostly in my mid to upper back. The chiropractor seems to think that maybe the pain I have been having may be associated with my body finally reacting to my legs being equal again. He said that normally happens at the beginning of treatment, but that most people don't have such a big leg length difference. Do you think I could be having a bad reaction to the chiropractic treatments or to the heel lift?

Answer
Jaci,

This is a difficult question to answer, and while I can give you a real slick answer and impress you with my knowledge, I'd likely be wrong.   This is guesswork.  Sorry.  There are too many questions.   The first is this: How do you know for sure you have an 11 mm leg length difference?   'Based on tape measurement? That's not accureate.  'Based on xray of your pelvis?  'Also, not accurate.  Was it based on x-ray of all your lower limbs so each bone could be measured?  That would be more accurate!  And, even if it was 11 mm, there is no evidence that fully correcting it would equate to total alleviation of bodily pain.  It's just not that cut and dry.   So here's my slick answer:  your pain may have nothing to do with the lift or the adjustments.   Maybe there is something else irritated in your back that the lift or adjustments do not address.   Please read the Q/A previous to yours where I discuss FASCIA.   If you have fascial irritation, then that must be dealt with with myofascial therapy and not just a joint manipulation (adjustment).   Here's part-2 of my slick answer: a) try changing the lift to a smaller one, b) check the arches of your feet/ankles to be sure you are not asymmetrically overpronating when you walk, and consider orthotics regardless (I'd recommend PowerSteps, Superfeet, or ALINE).   Lastly, since I'm a pot-stirrer, I cannot resist telling you that the odds of your piriformis being the bullseye are not likely.  The piriformis is only one of several buttock muscles and the current thinking is that it likely is not the culprit.  True piriformis syndrome causes sciatica into the calf/foot.  Regardless, your chiropractor must actively release all the fascial glue around you hip/gluteal's and up through the middle of your back with Active Release or Graston Technique or some other soft tissue mobilization method, and you must do strengthening exercises ("build a butt" and "stabilize the scap").  

'Hope this helps!  

Dr. G