To put more fuel on the fire:
Spine 1999 Apr 1;24(7):684-6
Is leg length discrepancy associated with the side of radiating pain
in patients with a lumbar herniated disc?
ten Brinke A, van der Aa HE, van der Palen J, Oosterveld F.
Department of Physical Therapy, Medisch Spectrum Twente, Enschede,
STUDY DESIGN: The association between leg length discrepancy and the
side of the radiating pain in lumbar disc herniation was investigated in
a case series. OBJECTIVES: To investigate whether pain tends to radiate
into the longer or shorter leg in patients with a lumbar herniated disc.
SUMMARY OF BACKGROUND DATA: No previous studies have investigated the
association between leg length discrepancy and side of radiating pain in
patients with a herniated disc. Results of studies of low back pain with
radiation and leg length discrepancy are inconsistent concerning this
association. METHODS: Of 132 consecutive patients admitted to a district
hospital for surgical management of a lumbar herniated disc, leg length
discrepancy was assessed using the indirect method as described by
Calliet. RESULTS: Seventy-three patients (55%) were men, and 59 (45%)
were women. The mean age was 40 years, and 99% of all herniated discs
appeared at L4-L5 (n = 60) or L5-S1 (n = 71). In 64 (62%) of the 104
patients with a leg length discrepancy of 1 mm or more, the pain
radiated in the shorter leg (P = 0.02). In subgroups of patients with
larger leg length discrepancies, similar results were found but because
of smaller sample sizes, these findings did not each statistical
significance. In 32 of the 57 men (56.1%), the pain radiated to the
shorter leg (P = 0.43); this was observed in 33 of the 47 women (70.2%;
P = 0.01). CONCLUSION: The results of this study showed a statistically
significant association between leg length discrepancy and the side of
radiating pain in a case series of patients with lumbar herniated discs.
The relation was more pronounced and statistically significant in women
John: not all (or most) spinal stability researchers are
Barrett: I agree with most of your points in the first post but as usual
I take exception with your comments:
> The "core researchers" have *not* been well-received by large portions of
> the research and clinical communities. The best resource for this is in the
> archives of the "Supertraining" list on Yahoo groups.
"Supertraining" is by no means the authoritative source of spinal
stability training. Some good points have been made there but they are
not novel in any way. Spinal stability is gaining more and more
respect. At this years world congress of biomechanics they set up a
special session on spinal stability. The panel (Hodges, McGill,
Panjabi, Solomonow, and Stokes) have a combined four Volvo awards for
research in low back pain. This is one of the most prestigious awards
in this area. Please don't tell me that none of these people are well
RCTs are supposed to be the pinnacle of evidenced based practice. I
have yet to see anyone criticize Hides et al.