High heels and narrow toe boxes lead to toe deformities in women

May 21 2011

According to a recent study, 39 percent of women say they wear high heels every day, and 75 percent of those women say they experience regular shoe-related foot pain and suffer from bunions, arthritic big toes, calluses, hammer toes, and plantar warts.

"Many women wear shoes to work every day that look great but they are simply too small," said Dr. Pedro Cosculluela, an orthopedic surgeon with The Methodist Hospital in Houston. "The biggest problems we encounter are related to the height of the heel and/or the narrowness of the toe box."

The narrow toe box makes it hard for many women to properly fit their entire foot into the shoe. This poor fit can lead to toe deformities in many women. These include bunions, hammertoes, and calluses. A bunion is a bump along the inside of the big toe, just before the joint. It is typically associated with deviation of the toe that is caused by external pressure from shoes that have a small toe box. With time, and ongoing improper shoe wear, the deformity and the bump become permanent and can worsen.

"As the deformity worsens, the big toe loses its ability to properly carry the load, which can lead to increase pressure along two through five. This can, in turn, lead to pain and cause hammertoes and cross-over toe deformities," Cosculluela said. "This, and other foot problems women experience because of poor shoe wear, do not happen overnight. It's a gradual process that can happen over a period of years."

Once you get a bunion, you cannot get rid of it. However, wearing toe pads over the bunions to prevent rubbing against the shoe will help ease the pain over the bump. Toe separators will help keep the big toe in place and ease pressure over the lesser toes, which can also alleviate pain. In cases that do not respond to conservative measures - such as shoe wear changes, orthotics, etc. - surgery is recommended in order to realign the joint, and establish proper weight-bearing distribution to the foot. Surgery also alleviates the pain associated with pressure over the bump.

High heels also bend the toes up and can move padding under the knuckles of the foot further down, exposing more bone to the bottom of the shoes, causing a great deal of pain. Cosculluela adds that the frequent use of high heels is associated with the development of tight calf muscles. This can lead other painful foot problems such as plantar fasciitis, flat feet and Achilles tendonitis.

"There is a simple test to find out if your shoes will fit before you buy them. Take a pen and draw around your bare foot," Cosculluela said. "Put the shoe over the drawing, if your toes stick out of the shoe, they are too small and you might want to try a bigger pair than will cause you much less discomfort."

SOURCE The Methodist Hospital