Short Leg Syndrome (Leg Length Discrepancy) Short Leg Syndrome happens when one leg is shorter than the other. A small difference (less than 1 cm) is common and usually harmless, but larger differences can affect posture, walking, and cause back, hip, or knee pain. Causes Structural: one bone is actually shorter (from birth, injury, or surgery). Functional: bones are equal, but muscle tightness, pelvic tilt, or posture make one leg act shorter. Symptoms Uneven hips, shoulders, or gait (limp) Back, hip, knee, or ankle pain (often on one side) Muscle tightness or sciatica in some cases Diagnosis Doctors measure leg lengths during exam or use X-rays. A simple “block test” (placing blocks under the short leg until the hips are level) can estimate the difference. Treatments Mild cases: shoe lifts, custom orthotics, physical therapy, posture correction. Severe cases (>2–2.5 cm): surgery to lengthen the short leg or shorten the longer one. Treating underlying causes (like arthritis) is also important. Why Early Detection Matters Fixing the problem early helps prevent long-term joint damage and chronic pain. If you notice uneven hips, shoulders, or unexplained one-sided pain, a doctor can check for leg length discrepancy.