how high heels affect your health

By Andrew D. Wagenheim, PA-C

Almost three-quarters of women wear high heel shoes at some time.  And many wear them for hours at work. Yet the question remains: Are high heels bad for you?

To help me find out, I decided to see my patients an entire day while wearing high heels. I share my experiences below.

How High Heels Affect Your Body

The general consensus among doctors is that wearing heels comes with a high price. Heels not only mal-align your feet, but also your knees, hips, back, and neck.  This secondarily leads to:

  • Blood restriction to your lower limbs (which can cause spider veins)
  • Shortened calf muscles
  • Stiffened Achilles tendon
  • Pain and muscle spasms
  • Knee pain
  • Back pain

Although blisters, calluses, and swelling in the feet sound like a real pain, back pain takes the cake! So why do heels cause your back to ache? Here’s why:

1. Heels cause changes in your posture. The S-curve of your spine is made up of cushion-like discs between the vertebrae that absorb shock waves from stress (caused by movements like bending or jumping). Wearing heels causes your lower back to arch more than normal because your body weight is being pushed forward. Your hips shift forward. To compensate, your upper body has to lean backward to maintain balance and proper posture. This puts extra stress on your discs. Spending hours in heels can lead to muscle spasms and back pain.

2. Heels cause changes to your body’s anatomy. Wearing heels on a regular basis can have a major impact on your body’s anatomy. Heels can shorten your calf muscles and tighten and thicken your tendons. Heels put extra strain on your back and knees causing these changes. Tightened calf muscles then alter how the rest of your body moves.

3. Heels increase the instability of your ankles and knees. Over time, this leads to arthritis and degenerative changes of your joints. Women have four times the amount of foot problems compared to males. The higher the heel, the more pressure you put on your forefoot. Here is how the height increases the pressure:

  • 1-inch heels: 22 percent pressure
  • 2-inch heels 57 percent pressure
  • 3-inch heels 76 percent pressure

4. Heels can lead to other spine injuries. Back pain from wearing heels can get even uglier if you have one of these spine injuries:

  • Spondylolisthesis: a common injury that affects your lower back from arching your back too much (hyperextension). It occurs when one of your vertebrae slips forward over another.
  • Foraminal stenosis: a spine and nervous system issue that occurs when anatomical abnormalities reduce the spaces the nerves travel through as they exit the spine. These space pockets are called foramina and when they are blocked, they squeeze your nerves. The pain can radiate down your buttocks and legs. Symptoms include shooting pain, numbness, tingling, muscle weakness, spasms, and cramping.
  • Sciatica: Your sciatic nerve is the longest nerve in your body. It runs from the bottom of your spine to your legs. When your sciatic nerve is compressed, it causes radiating pain, tingling, numbness, and muscle weakness down your legs, which can travel to the bottom of your feet.

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Kick Off the Heels!

If you are experiencing back pain from regularly wearing high heels, it is time to retire your favorite pumps. Flat shoes can be very chic. Have you checked Pinterest lately? Wearing shoes that are designed for comfort can help alleviate your pain and help you live a more pain-free life.

High Heels a Must? Here Are Some Tips to Alleviate and Prevent Potential Back Pain

Even after reading the negative effects heels can cause, you may not be willing to give them up just yet. Here are some tips to help alleviate your back pain.

  • Wear heels for as little time as possible.  Take comfortable shoes with you to the office in case you have to walk long distances.
  • Opt for heels around 2 inches high or lower.  The higher the heel, the more pressure you are putting on your forefoot.
  • Steer clear of pointy-toed shoes. 
    Pointy-toed shoes can cause more discomfort than other types of heels.
  • Buy shoes with leather insoles. 
    Leather insoles help keep your feet in place inside of your shoe and reduce sliding.
  • Buy arch inserts.  Arch support is key to a healthy back. Having a shoe with no arch support can cause major back pain. If you can’t find shoes with built-in arch support, buy some to insert in your favorite pair of heels.
  • Vary your shoe choices.  Switch up your wardrobe – including your shoes. Switch between flats and heels so you give your back a break.
  • Style is everything. 
    Instead of wearing stilettos, opt for a pair of platforms or wedges. Gradual or lower slopes are better for your back.
  • Thicker is better.  Thicker heels provide more support than stilettos or spiky heels. Choose a chunky heel to complete your look.
  • Stretch! After a long day in heels, it is important to stretch and strengthen your sore muscles.

  • Stretch your leg and hip muscles. Find a stretching routine that works for you. Be sure to work your thigh and calf muscles before and after wearing heels.
  • Massage and stretch your feet muscles. Roll your feet on a golf ball or treat yourself to a foot massage. Your feet will thank you for it!
  • Improve motion in your ankles. Roll your ankles while sitting at your desk. This will help alleviate some of the stiffness and tightening that comes with wearing heels.

My Day in Heels

I was only in the heels for a short period of time.  This was not enough time to develop musculoskeletal adaptations from wearing the heels.  However, I did notice that I needed to increase the arch of my back to stand up correctly.  By being on your toes, this moves your body of mass forward.  Therefore, I have to increase the arch in my back to maintain an upright posture.  Over time, this would become second nature and I would not even know that I am modifying my posture.  Eventually, this would lead to chronic back pain or place me at a risk for an acute back injury.

Suffering from Back Pain?

The National Institutes of Health reports that back pain – either acute or chronic – affects eight out of 10 people. If you’re suffering, you can count on UPMC Pinnacle to understand your needs and work with you toward the best treatment option.

After an initial assessment of your condition is complete, your information will be reviewed by a medical professional and an appointment will be scheduled with the appropriate provider. Visit us online for more information.

About UPMC Harrisburg

UPMC Harrisburg is a nationally recognized leader in providing high-quality, patient-centered health care services in south central PA. and surrounding rural communities. UPMC Harrisburg includes seven acute care hospitals and over 160 outpatient clinics and ancillary facilities serving Dauphin, Cumberland, Perry, York, Lancaster, Lebanon, Juniata, Franklin, Adams, and parts of Snyder counties. These locations care for more than 1.2 million area residents yearly, providing life-saving emergency care, essential primary care, and leading-edge diagnostic services. Its cardiovascular program is nationally recognized for its innovation and quality. It also leads the region with its cancer, neurology, transplant, obstetrics-gynecology, maternity care, and orthopaedic programs.

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