A New Outlook on Treatment for Pain from High Heel Shoes

By Dr. Daniel Pero –
A New Outlook on Treatment for Pain from High Heel ShoesIf you are like most women who love to wear your high heel stilettos, but then pay the price for it later, you are definitely not alone.  Have you ever struggled to keep up with appearances 6 inches taller and try so desperately not to grimace from your aching feet while going out? And then choose a different pair of heels the following day in hopes that you will have some relief despite the same contorted position you are placing your foot in again? Of course you have. I’d like to coin a new term in the ever-growing fashionable medical community if I may, Stiletto Syndrome: Pain and injury related to the wearing of high heel shoes.
In the past, the typical advice that would be given by a foot specialist when you say, “My feet hurt after wearing high heels” has been, you guessed it, “Don’t wear them.” Makes sense right? Sure it does. But who is going to listen? In my experience, not many people. Should a doctor be surprised that their patients do not want to flaunt that new black dress and accessorize it with a new pair of grey and blue cushioned running shoes? I hope not. At times I feel that when appropriate, it is necessary to tailor my treatment plan, within reason, according to my patients’ lifestyle. For example, if someone’s place of employment requires a certain type of attire, I cannot ask them to quit their job and look for a new one, especially during these trying times.
So let’s look at some possible alternatives to those “ugly flats” and tennis shoes. How about PREVENTION? Or how about EXERCISE? Do these sound like viable options to treat pain in this broken healthcare system I’d like to refer to as “sick care”? I would sure hope so. And why would this type of problem be treated any differently than other ailments that are brought on by lifestyle choices such as smoking, drinking, over-eating, poor nutrition, lack of sleep, and lack of exercise? I don’t see why not! Quite simply, if your lifestyle put you in the situation you are in, make some changes to your lifestyle.
Harmful Effects of High Heels
To summarize the harmful effects of wearing stiletto shoes, there are a few areas throughout the body that suffer most and I’ll shed some light on the reasons why. Then I’ll touch on how these can be prevented or treated in the office and at home.
Biomechanically speaking, wearing high heel shoes moves the body’s center of gravity forward and places most of the body weight on the ball of the foot. This, and a narrow toe box in these pointy shoes, can cause pain in the forefoot, or metatarsalgia, pinched nerves (neuritis and neuromas), and can accentuate the progression of familial deformities known as bunions and hammertoes. Don’t forget about the calluses or “corns”.
The toes are in the dorsi-flexed position, and this creates tension on the plantar fascia of the foot, which can cause pain and soreness with every step.
Next, the ankle is fixed in a plantar-flexed position, which after prolonged periods of time can cause the Achilles tendon and muscles behind the calf to shorten or tighten. This can lead to pain when wearing flat shoes, tendonitis, heel spurs, and progression of the forefoot deformities mentioned above.
Then we have the front of the knee, behind the kneecap, which is taking up more pressure within that joint from the forward center of gravity. This shift also causes the muscles in the front of the hip and thigh that move the leg forward to walk fatigue and tighten, causing a tilt in the pelvis, which in turn can cause low back pain. All of these abnormal positions and movements eventually cause muscle imbalances, pain, soreness, burning, ingrown toenails, and toe spasms, as well as chronic pain in the upper back, shoulders, and neck, which accumulates from all the added stress. And again, the progression of bunions and hammertoes.
Prevention and Treatment
Each of these areas can be targeted with unique exercise routines that address the unsound biomechanics with wearing high heels. First, adding a few specific stretches and strengthening exercises to your daily or weekly routine which hopefully already exists, can be very beneficial to help prevent the aches and pains and injuries of wearing stilettos. In addition, a quick regimen of exercises should also be employed every time you wear them. These can all be discussed in the office and literature can be taken home for home therapy. Also, the quality and structure of the shoe can be addressed in the office based on your foot type, arch height, and pre-existing conditions that may need to be treated with cushioning, and offloading or padding of the forefoot and heel. Topical prescription and compounded medications can be dispensed as well.
So if giving up the high heels is simply not an option for you, now there actually are some answers on how to improve how you feel and prevent injury from wearing them.
Dr. Pero and Dr. Michel at the Integrative Foot & Ankle Center have been successfully treating patients in Palm Beach County for medical, surgical, age-related, cosmetic, and biomechanics-related conditions for several years. Call today to schedule your appointment and learn about new options of which you may have not been aware.
INTEGRATIVE FOOT & ANKLE CENTER
DR. DANIEL PERO and DR. KARL MICHEL
WWW.INTEGRATIVEFOOT.COM
(561) 293-3439

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