The effect of high-heeled shoes on lumbar lordosis: a narrative review and discussion of the disconnect between Internet content and peer-reviewed literature.
OBJECTIVE
Some women complain of low back pain that they believe is due to wearing high-heeled shoes, and some clinicians seem to think the reason is that high-heeled shoes cause increased lumbar lordosis. This article examines Internet information aimed at the general public and presents a literature review of available research in this area.


METHODS
The keywords high heels and high-heeled shoes, combined with the words lumbar, lordosis, and pelvic tilt, were used in an Internet search of Ask.com; in published literature searches of PubMed, MANTIS, CINAHL, Scopus, and ProceedingsFirst; and in searches for theses and dissertations of PapersFirst through June 2010.


RESULTS
There are many Internet sites that support the belief that high-heeled shoes cause increased lordosis. However, published research for this topic mostly does not support this belief; but some mixed results, small subject groups, and questionable methods have left the issue unclear.


CONCLUSIONS
It appears that some health care providers are offering advice about the effect of high-heeled shoes on lumbar lordosis that conflicts with most published research. However, the prevalence of such advice is unknown; and the published research is equivocal. Considering that both low back pain and the wearing of high heeled-shoes are common, clinicians could use some clearer guidance; this is an area that deserves further investigation.
Brent S
BS
Russell