Avoid Back Pain by Ditching High Heels

Wearing high heels can make you feel taller, glamorous and fashionable. But are these benefits worth the painful consequences?

High-heeled shoes affect your body’s center of gravity and change your body’s alignment, compromising back support and posture. When you wear high heels, you put your feet in a downward position, which places excess pressure on the front of your foot. This completely distorts your center of balance, forcing the rest of your body to compensate. The lower part of the body leans forward, while the upper body must lean back. This is not the body’s normal standing position. Poor alignment can result in muscle overuse and back pain.

Your back’s normal s-curve acts as a shock absorber, reducing stress on the spine. Wearing heels causes the lower part of your back to flatten out, pushing your head and upper spine backwards. This places increased pressure on the small joints of your spine (facet joints), causing pain. In addition, the muscles in the upper front part of your thighs have to work much longer and harder during walking due to the downward position of your feet. If you regularly overuse these muscles, they can shorten permanently, which can also cause your spine to flatten.

Heard enough? Well, there are even more reasons to keep your heels in the closet. Heels can cause foot problems as well as worsen existing foot problems. The higher the heel, the more pressure put on the bottom of the forefoot. This can lead to pain or deformities such as bunions, hammer toes and neuromas. High-heeled shoes can also cause your foot and ankle to turn towards an outward position, putting you at risk for losing your balance and spraining your ankles. This outward position also puts pressure on the back of the heel, which can cause a deformity over the Achilles tendon called pump bump (Haglund’s deformity). This can cause local inflammation, pain and ultimately, lead to the end of high heels for a while.

Lastly, because heeled footwear increases the distance between the floor and your knee, you’re more prone to increased knee torque–which can lead to early onset joint degeneration over time (osteoarthritis).

Now, with all of this information in mind, do I expect women to give up heels all together? Of course not. The concept that high heels help women appear more feminine or attractive is not just a myth; it has been backed up by scientific research. In 2012, British researchers evaluated the effect of 6-inch high heels versus flats on femininity and attractiveness in both male and female observers. Both male and female observers felt that heels significantly increased a woman’s attractiveness and femininity vs. flats. Therefore, to decrease the risk of injury and developing pain, here are some concepts to keep in mind when buying footwear:

  • Don’t wear shoes that are pointy or very narrow in the front. You will be more apt to get bunions and neuromas.
  • Avoid open back or slide-on shoes that require toe gripping. This can result in hammer toes and foot tension.
  • While the ideal height is no heel, a two-inch heel will cause less pain or damage than higher ones.

If you are experiencing an acute episode of low back pain, ditch the heels at least until your pain resolves, instead opting for flat shoes, such as sneakers or sandals, as these will be a much better choice for your back and posture.

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