Leg length differences can be structural (meaning you're born with it) or functional (resulting from spinal compensation).
Functional leg length inequality suggests an imbalance within the spine and/or pelvis. It's the end of the chain, so to speak, or the last thing to happen as the spine compensates and adapts to structural stress/strain.
Many people with back problems have a subtle leg length difference, but not all people with this difference have back problems... so it's not diagnostic.
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