Question: Im a 28yo white male, athletic, fit (5'11" 175lbs), no health problems whatsoever, except constant lower back pain and associated pains. As seen in the attached xray, my right leg is about 22mm shorter than my left (measured in the xray viewer tool by a spinal orthopedic doctor). I sometimes have sciatica like leg pain shooting down my right leg, initiating deep within my hip. I have constant back pain of about a 2-4/10 pain scale. I cant remeber a weekend or a week without back pain in the last 2-3 years. I can only wear hard soled supportive shoes or its 5x worse that day. Sitting at a desk or in the car makes it worse, but so does standing and walking all day. Weekends feel the best when I can lay down and relax often. For 2 years I have been wearing a 3/8in adjust-a-lift heel insert in my right shoe consistently. My doctor reviewed MRI results today from a lumbar MRI scan that was conducted yesterday. He said there was no fractures, breaks, nerve damage, herniated discs or other issues he saw, besides a little bit of arthritis that is in my lower back. Also, while I still quite flexible, my flexibility in my right hip is about 20% worse than my left hip. My doctor has said there isnt really a solution besides wearing the heel inserts (which I've done with little to no improved results). He has referred me to see a physical therapist. He assumes this is a structural issue of my leg being shorter rather than a functional. I did have back pain dating all the way back to when i was at least sixteen or earlier when a chiropractor adjusted me and said visually I had about a 1/2 inch discrepency between my leg lengths that he was able to adjust to about 1/4inch. Is there anything else I can do? This is starting to affect my motivation at work, my enegery and overall quality of life and I am only 28. Any help is greatly appreciated!

I work out very frequently and often try and correct poor posture. Will this be something that the PT will help correct? Do you have any other suggestions? I care much more about the long term solution than any temporary pain relief. Also while resting helps in most positions, laying flat on my back makes my lower back burn (i assume this is inflamation). Would the custom orthotics also help, since i have severe over pronation in the longer leg?

What about an alignment such as chiropractic manipulation to help realign my hips. As i have mentioned this supposedly corrected it by 1/4 of an inch years ago. Is that a common or accepteable appraoch, combined with physiotherapy, orthodics and other advice?