By Steve Hefferon, CMT, PTA and co-founder of LoseTheBackPain.com

One of the questions we get very often here at the Healthy Back Institute is, do heel lifts cause back pain?

Well, the answer is, yes, they can and often do and that is why we discourage people from going straight into heel lifts. Back pain sufferers need to understand why wearing lifts might end up prolonging their pain. Heel lifts can work against you achieving the physical balance necessary for a pain-free pelvis or back.

Knowing the right question makes whoever is answering think more, communicate better and give you a clearer answer. If a healer says you have one leg shorter than the other, always ask, "Are we talking about a leg-length difference or a leg-length discrepancy?"

A leg-length difference occurs when the length of bones are different between one leg and the other. The way to measure is by x-ray. A leg-length discrepancy, however, is when one leg appears to be shorter because one side of your hip has gone higher than the other. The difference between these two conditions is vital when it comes to recommending use of a heel lift.

A client once complained to me that his 5/16th of an inch heel lift did not feel right. We tried removing it, but this was not satisfactory, either, so I recommended asking his doctor for an x-ray. We discovered the real difference in length between his two legs only amounted to 1/16th of an inch. The lift's extra 4/16th of an inch was actually keeping my client from developing the physical balance necessary to achieve pain-free living.

1/16th of an inch difference is not a lot, and our bodies can accommodate it. But, first, you and your doctor need to know if you have a difference or a discrepancy. Physical therapists, podiatrists or medical doctors will have you using a lift to provide a momentary answer, but lifts are not good for improving long-term balance and a more stable pelvis.

It is possible to be born with legs of different length. Also, total hip or knee replacement patients may have significantly shorter legs. However, doctors should never assume this condition exists and recommend heel lifts, or orthotics with built-in lifts without digging further to understand what's actually going on for the individual.

Leg-length discrepancies are often caused by how we hold ourselves, how we stand. Women carrying babies on one hip, say, can produce discrepancies. In general, habits, patterns, posture and positioning — things we do all day long — control the way our pelvis is conditioned. Very specific sets of muscles are associated with a discrepancy. Until you know your true condition, you cannot know exactly what to do.

When lift-wearers know which condition they suffer from, the next step is to work with the maker of the lift to gradually decrease its height as you increase your strength and bring your body back to a more balanced, more stable state. This is the ideal: to be natural and balanced so you can withstand the stress and strain of your day.

Once I accurately diagnose a client's condition, what makes all the difference in dealing with their pain are stretching and exercising. Not any haphazard program, either, but an integrated corrective exercise program tailored specifically to the individual client's special needs. I always and whole-heartedly recommend our Muscle Balance Therapy approach as the foundation of any back pain relief plan.

Muscle Balance Therapy, first of all, makes possible understanding how and why your body is out of alignment. It helps identify muscle imbalances and postural dysfunctions which are the root cause of your pain. Then a program of very specific and personally targeted exercises help your body become stronger, more flexible and better balanced.

Starting today you the sufferer can take control of achieving the long-term relief that comes with a more neutral, natural and stable pelvis. Muscle Balance Therapy has worked for thousands of back and pelvis pain victims worldwide. In all sincerity, let me ask you what I believe is the right question. Isn't it time to get rid of your heel lifts?