High heels and bad backs. Is there a link? This is a question I’m sometimes asked by my female patients experiencing low back problems. Many women I’ve spoken to on this issue swear that wearing stilettos – particularly for longer periods of time – brings about some discomfort to the lower back. My Mum, for example, finds it virtually impossible to wear high heels at all, though she has a long standing injury. So as we swing into party season should you be strutting out in your 5 inch heels or going for something a little more reserved?
It depends. No one is the same and many women will never struggle with heels at all during their lifetime. Anecdotally most chiropractors will tell you that their female patients often complain that there’s definitely a link between high heels and bad backs, and there’s always been a high probability that heels can cause a problem because they push the heel upwards into an unnatural position, causing the centre of gravity to shift and the back muscles are then employed to compensate. However, until recently there has been precious little research into this area and we could only say as practitioners that yes, it is highly likely that heels cause a problem because of what we know about how the body works. As recently as 2010 a narrative study by an American chiropractor opined that the jury was out and more research was necessary. The piece was published in the U.S National Library of Medicine and can be viewed here.
Well now we seem to have that research and the results are pretty clear. No, ladies, you haven’t been imagining that back pain after wearing high heels. It’s very real and is caused by your choice of footwear. The latest study published earlier this year (it can be seen in PDF form here) collated other research in this area so as to form an overview. The references for that research can be found at the foot of the document.
The conclusion was clear – walking in high heels has an effect on the mechanics of the foot resulting in body imbalance and unnatural muscle activation of the trunk and leg muscles. This tends to confirm what most of us have known for some time. If you can avoid wearing high heels then do so. Try not to wear them all day at work, for example. If you can’t avoid wearing them because you have a wedding or other event to go to and you just can’t bring yourself to throw out your favourite pair then try not to wear them for prolonged periods.