High-Heeled Shoes and Musculoskeletal Injuries

Post on February 2, 2016 by André Broussard, D.C.

February 02, 2016
BMJ Open

TAKE-HOME MESSAGE

  • The association between wearing high-heeled shoes and the development of musculoskeletal pathology was assessed in this systematic review of 18 studies. The researchers found an association between high-heeled shoes and hallux valgus in three of four articles, an association with pain in three of five articles, with first-party injury in seven of eight articles, and with osteoarthritis in neither of two articles.
  •  Wearing high-heeled shoes appears to be associated with hallux valgus, pain, and injury, but not osteoarthritis.

Abstract

OBJECTIVES

To conduct the first systematic review from an epidemiological perspective regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, osteoarthritis (OA) and both first-party and second-party injury in human participants without prior musculoskeletal conditions.

SETTING

A systematic review of international peer-reviewed scientific literature across seven major languages.

DATA SOURCES

Searches were conducted on seven major bibliographic databases in July 2015 to initially identify all scholarly articles on high-heeled shoes. Supplementary manual searches were conducted. Titles, abstracts and full-text articles were sequentially screened to identify all articles assessing epidemiological evidence regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, OA and both first-party and second-party injury in human participants without prior musculoskeletal conditions. Standardised data extraction and quality assessment (Threats to Validity tool) were conducted.

PRIMARY AND SECONDARY OUTCOME MEASURES

Musculoskeletal pain or OA as assessed by clinical diagnosis or clinical assessment tool. First-party or second-party injury.

RESULTS

644 unique records were identified, 56 full-text articles were screened and 18 studies included in the review. Four studies assessed the relationship with hallux valgus and three found a significant association. Two studies assessed the association with OA and neither found a significant association. Five studies assessed the association with musculoskeletal pain and three found a significant association. Eight studies assessed first-party injury and seven found evidence of a significant injury toll associated with high-heeled shoes. One study provided data on second-party injury and the injury toll was low.

CONCLUSIONS

High-heeled shoes were shown to be associated with hallux valgus, musculoskeletal pain and first-party injury. No conclusive evidence regarding OA and second-party injury was found. Societal and clinical relevance of these findings is discussed. Concern is expressed about the expectation to wear high-heeled shoes in some work and social situations and access by children.

Journal Abstract

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