Improvement of L4-L5 disc positioning following treatment with orthotics used to correct gait dysfunction and level the sacral base

Sacral base unleveling and gait dysfunction is a source of asymmetrical posture, possibly causing disc malpositioning over time. We present a patient diagnosed with right on right forward sacral torsion, a short left leg, gait dysfunction and lumbosacral somatic dysfunction, and an MRI work-up showing a disc extrusion and neural foramina narrowing at L4-L5 and L5-S1. Approximately 10 weeks after receiving treatment, and being pain free, she returned because of exacerbation of her back, and was sent for a second MRI, which described an unexpected improvement, namely only a mild protrusion at L4-L5 without mention of neural foramina narrowing. Our objective in presenting this case is to demonstrate the possibility that improving gait and leveling the sacral base with the use of heel lifts and orthotics may improve disc malpositioning. Further studies are needed to determine if proper alignment improves disc positioning and through what mechanism this occurs.