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. Conclusion: For women aged 40-66 years wearing of high-heeled shoes had not caused foot deformation, but more foot pain and callosities. (C) 2015 The Authors. Published by Elsevier Ltd on behalf of European Foot and Ankle Society.