High Heels: Back Pain and the Price of Fashion

By Martin Brown

You don’t need the team from CSI Miami to figure out that the suspect in many cases of back pain is the shoes that look so great on your feet but are not so good for your feet, legs, and particularly your back.

Last week, in the first part of this two-part series, we discussed how often poor posture is the root cause of back pain.

For women another common cause of lower back pain can be those dressy high heeled shoes, or at the other end of the fashion spectrum, those casual flip flops.

It’s frustrating to realize that the wrong pair of shoes can cause such discomfort. It would be nice if your favorite shoes pleased your skeletal system as much as your sense of fashion. But to avoid what can develop into debilitating pain, there are times when appearance has to take a back seat to comfort and good sense.

Shoes are critical to back support in today’s “concrete jungles.” Don’t forget that our shoes are the one part of us that comes in contact with the ground. And that ground can often be most unforgiving. Our ancestors ran barefoot along a far more forgiving surface: leaf strewn forest floors, muddy paths, sandy beaches. Even a dry dirt path is more forgiving then the concrete sidewalks we walk on today.

Now add to the jarring impact of today’s streets, high heels that challenge the ability of feet to provide much needed support for our pelvic and lower back structure and you have a recipe for trouble. Many women commonly complain that they were able to wear high heels when they were younger but have had increasing difficulty doing that past the age of thirty-five. There are two reasons for this, the first is a natural loss of flexibility in the musculoskeletal system making the same instability a greater challenge then it was at age 20, and second, the lack of stretching exercises to maintain higher levels of flexibility.

If wearing high heels is a must, the least you can do is to put air-cushioned inserts in your shoes. This will lessen the jarring motion that occurs when you hit an unforgiving surface and support the heel of your foot as it attempts to absorb more of that impact even though it is perched at an angle well above the ball or your foot. Second, do some online research as to the comfort and support various shoes offer.

Some high heel shoes offer greater stability and support than others so when you have an occasion in which you feel that high heels are essential you at least have a better chance of supporting your feet, legs and lower back. One other mitigating action you can take is to be more diligent about stretching and back support exercises. Maintaining flexibility and strength in the pelvic lower back region will help you stay comfortably in heels for longer periods of time.

Finally, beware that flat flip-flops can be problematic and a substantial source of back problems in their own right as well. The principle problem with flip-flops is that they offer the heel no stability and very little cushioning from the pounding they take when hitting a concrete surface.

A proper shoe always supports your heel with a strap or a cup, giving you the help your feet need to survive in the jungles of today.


Martin Brown is the Heath Channel Editor for SingleMindedWomen.com, and co-author of The Complete Idiot’s Guide to Finding Mr. Right.

His next book, Fit in 50 Days, will be available May 2011.