It's no secret that high heels are bad for the feet. But a new study documents the risks.

A study of 3,300 men and women found that nearly 64 percent of older
women who reported hind-foot pain regularly wore high heels, pumps or
sandals at some point in their lives.

The study found no connection between foot pain
in men and the shoes they wore, largely because they don't typically
wear high heels and spend less time in sandals, the researchers
concluded.

"We found an increased risk of hind-foot pain among women who wore
shoes, such as high heels or pumps, that lack support and sound
structure," said study team member Alyssa B. Dufour, a graduate student
at the Institute for Aging Research of Hebrew SeniorLife.

Ignoring the problem

Humans have been wearing shoes for about 40,000 years. In the past century or so, the consequences have become well-known.

Foot pain is one of the top 20 reasons people ages 65 to 74 visit a
physician, the researchers say. About 30 percent of women report the
problem, as do about 20 percent of men. Scientists have not known for
sure what's behind the discrepancy, though other studies have hinted at
reasons.

People who don't wear shoes at all have wider feet and a bigger gap between the big toe and the next.

Women who spend a lot of time in high heels wind up with smaller
calf muscles. And high heels are known to put excess pressure on the
balls of the feet and squeeze the toes together. Over time, the foot
can curve inward.

As often is the case, fashion trumps health. Increasingly women are getting cosmetic surgery
to shave down the bones of their toes or are getting Botox injections
to loosen the muscles pulling on the toe (cosmetic surgery sales have sagged during the recession, though).

Going minimal seems not to be the answer, either.

The new study lumped sandals in with high heels in the "poor
footwear" category. And a separate study last year found that wearing
flip-flops non-stop alters the way a person walks, leading to problems with the ankle, heel and sole.

Some, including the Society for Barefoot Living, claim that going
without footwear is the answer. But that's not practical in much of
modern society, critics point out.

Footwear choices

The new study puts shoes into the following categories:

Poor: high heels, pumps, sandals and slippers.
Average: hard- or rubber-soled shoes and work boots
Good: athletic and casual sneakers.

"Young women should make careful choices regarding their shoe types
in order to potentially avoid hind-foot pain later in life," Dufour
said.

The findings are detailed in the October issue of the journal Arthritis Care & Research.

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