A large selection of the population wears high heels for most of the day. According to podiatrists, chiropractors, doctors and physiotherapists, women who wear high heels most of the time are at high risk of developing a number of foot, back and neck problems. One can assist a client strike the balance between fashion and sensibility by giving good advice and education. Wearing heels can result in many conditions that could be avoided if use is limited or eliminated. This article will discuss four common conditions caused by long term high heel use.
Conditions: High heels may cause one or more of the following conditions:
- Back ache/pain
- Achilles tendonopathy
- Bunions
- Morton’s neuritis
What Causes Back Pain?
When standing in high heels, the body undergoes a postural change, shifting the person’s centre of gravity forward. The back becomes arched and the chest and pelvis are thrust forward. In order to accommodate this new posture, the body undergoes joint and muscular adjustments. These adjustments typically cause pain in the lower back as the muscles attempt to maintain balance.
What Causes Achilles Tendonopathy?
The wearing of high heels results in the shortening of the Achilles tendon. This causes the calf muscles to contract and form the attractive muscle definition sought by heel wearers. However, extended periods of time in this position cause the tendon to contract and may result in discomfort and pain when the sufferer wears flat shoes.
What Causes Bunions?
A bunion is a bony prominence on the base of the joint of the big toe. The big toe is often angulated towards the second digit. Often high heels force the toes into a tight enclosed space which places this prominence under frictional pressure. This increases bone turnover locally causing the area to become more prominent and inflamed.
What Causes Morton’s Neuritis?
This is a condition when one or more of the sheaths surrounding the nerves on the dorsal aspect of the metatarsals become thickened and inflamed. This usually occurs between the third and fourth metatarsals. High heels force the fore-foot into a close, confined space that is usually too narrow to comfortably contain it. This causes mechanical irritation of these nerves and is characterised by numbness and a burning sensation in the toes.
Treatment
The success of treatment is based largely on the client’s willingness to comply with advice. The main aim of treatment is to reduce the amount of time the client wears in high heels.
- Analgesics: Paracetamol (Panado® tablets) may be advised to relieve symptoms by reducing the production of prostaglandins. Care must be taken to ensure the client has no allergies to ingredient.
- Time: Encourage the client to avoid wearing high heels for extended periods of time and to wear flat, comfortable shoes at home or whenever possible.
- Stretching: Stretch calf muscles throughout the day to discourage Achilles tendon shortening.
- Education: Educating a client about the complications of long term high heels use may encourage the client to wear adequate shoes. Avoid a high heel with pointed toes.
High heel wearers account for a large percentage of people complaining of foot pain. Good shoe-wear advice and education play a large role in preventing the conditions listed above.
