Association of low back pain with the use of high heel in ladies: a systematic review

Background & Objective: High heels of shoes are preferred for attractiveness, but are detrimental to health regarding their biomechanics. High heel changes the joint mechanics during walking which may result in abnormal stress and pressure at certain points and thus lead to painful knee, foot, hip or low back pain. The objective of this systematic review was to evaluate the literature addressing the association between the high heeled shoes and low back pain among females.Methodology: It was a systemic review conducted during 2014-2020 on databases including Cochrane Library, PubMed, Medline, PEDro and Scopus, with key words 'Low back pain' OR 'Back pain OR Lumbago', 'Low back pain in females OR Back pain in females OR Lumbago in females', 'High heeled shoes OR High heels', 'Association OR relationship'. Available full-length papers in English language were explored, after the screening and quality assessment using Axis critical appraisal tool for the studies.Results: We found 32 articles, but the inclusion criteria were met only by 11 studies in quality score of 16. 27/20. The eligible studies enrolled a total of 1334 female participants with an average age of 18-32 y. Nine studies explained that low back pain was associated with high heeled shoes but none specified height of the heel, and only a range of 2.5-11 cm was suspected to be associated with changes in lumber biomechanics or lordosis, that can exert extra pressure for postural adjustments and lead to low back pain. Conclusion: Out of 11 studies, nine studies favored that low back pain was associated with high heeled shoes, there was no specific height mentioned; but only a range of 2.5-11 cm was found to be associated with biomechanical changes due to postural adjustments, being a possible cause of low back pain among females.