Does the use of high-heeled shoes lead to fore-foot pathology? A controlled cohort study comprising 197 women.
BACKGROUND
High-heeled shoes have been suggested as a main explanation for the female dominance in foot pain and deformities. Aim of study was to test this hypothesis scientifically.


METHODS
Women 40-66 years were included in two groups. 95 women who had worn high-heeled shoes at work for at least 5 years were compared to 102 women who had never worn high-heeled shoes at work. The investigations were weight bearing radiographs of foot and ankle, the SEFAS questionnaire and the AOFAS Clinical Rating System. Evaluators were blinded to the group-affiliation.


RESULTS
Radiographs showed no statistically significant differences between the two groups concerning deformities or joint disease. Foot function measured by SEFAS and AOFAS total score, were similar in the two groups. The high-heeled group had more pain and more callosities.


CONCLUSIONS
For women aged 40-66 years wearing of high-heeled shoes had not caused foot deformation, but more foot pain and callosities.
Department of Orthopaedic Surgery, St. Olavs University Hospital, Trondheim, Norway. Electronic address: Grethe.Borchgrevink@stolav.no.
Grethe E
GE
Borchgrevink
Department of Radiology, St. Olavs University Hospital, Trondheim, Norway.
Annja T
AT
Viset
Department of Orthopaedic Surgery, St. Olavs University Hospital, Trondheim, Norway.
Eivind
E
Witsø
Institute of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Obstetrics and Gynaecology, St. Olavs University Hospital, Trondheim, Norway.
Berit
B
Schei
Department of Orthopaedic Surgery, St. Olavs University Hospital, Trondheim, Norway.
Olav A
OA
Foss
D000328:Adult; D002145:Callosities / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D005528:Foot / Q000503:physiopathology; D005531:Foot Deformities, Acquired / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D006215:Hallux Valgus / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000503:physiopathology; D015995:Prevalence; D012016:Reference Values; D018570:Risk Assessment; D012775:Shoes / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D016474:Weight-Bearing
Foot deformities; Foot pain; Footwear; Hallux valgus; High-heeled shoes