The effect of high-heeled shoes on lumbar lordosis: a narrative review and discussion of the disconnect between Internet content and peer-reviewed literature

Brent S Russell, Brent S Russell

Abstract

Objectives: Some women complain of low back pain that they believe is due to wearing high-heeled shoes, and some clinicians seem to think the reason is that high-heeled shoes cause increased lumbar lordosis. This article examines Internet information aimed at the general public and presents a literature review of available research in this area.

Methods: The keywords high heels and high-heeled shoes, combined with the words lumbar, lordosis, and pelvic tilt, were used in an Internet search of Ask.com; in published literature searches of PubMed, MANTIS, CINAHL, Scopus, and ProceedingsFirst; and in searches for theses and dissertations of PapersFirst through June 2010.

Results: There are many Internet sites that support the belief that high-heeled shoes cause increased lordosis. However, published research for this topic mostly does not support this belief; but some mixed results, small subject groups, and questionable methods have left the issue unclear.

Conclusions: It appears that some health care providers are offering advice about the effect of high-heeled shoes on lumbar lordosis that conflicts with most published research. However, the prevalence of such advice is unknown; and the published research is equivocal. Considering that both low back pain and the wearing of high heeled-shoes are common, clinicians could use some clearer guidance; this is an area that deserves further investigation.

Copyright © 2010. Published by Elsevier Inc.

Figures

Fig 1
Fig 1
At least 2 studies used wooden blocks placed under the heels, instead of actual shoes.
Fig 2
Fig 2
Lee et al measured angles based on markers placed in the lateral midline and did not evaluate the lumbar spine itself.

References

    1. Franklin M.E., Chenier T.C., Brauninger L., Cook H., Harris S. Effect of positive heel inclination on posture. J Orthop Sports Phys Ther. 1995;21(2):94–99.
    1. Opila K.A., Wagner S.S., Schiowitz S., Chen J. Postural alignment in barefoot and high-heeled stance. Spine. 1988;13(5):542–547.
    1. de Lateur B.J., Giaconi R.M., Questad K., Ko M., Lehmann J.F. Footwear and posture: compensatory strategies for heel height. Am J Phys Med Rehabil. 1991;70(5):246–254.
    1. Buehler V.L. University of Oregon; Eugene, Oregon: 1932. The effect of various heights of heels upon erect body posture and an investigation of the possible reasons [thesis]
    1. MailOnline [homepage on the Internet]. Associated Newspapers, Ltd; c2010 [updated 2008 August 26; cited 2010 June 4]. Apprentice star Claire Young: my killer heels wrecked my spine and left me in agony. Available from: .
    1. American Chiropractic Association [homepage on the Internet]. Arlington, Virginia: American Chiropractic Association; c2009 [cited 2010 June 4]. Today's fashion can be tomorrow's pain. Available from: .
    1. American Physical Therapy Association [homepage on the Internet]. Alexandria, Virginia: American Physical Therapy Association; c2009 [updated 2000 August 20; cited 2009 May 18]. Physical therapists say tottering on high heels puts women at risk for foot and back problems. Available from: .
    1. Sutton A.L., editor. Back and neck sourcebook. 2nd ed. Omnigraphics; Detroit: 2004. p. 116.
    1. Physical Rehabilitation/Robert Egert, M.D. [homepage on the Internet]. Chico, CA: Robert Egert, MD. [cited 2010 June 4]. Low back pain; posture and lifting advice. Available from: .
    1. McKinley Health Center [homepage on the Internet]. The University of Illinois at Urbana-Champaign; c2007 [updated 2007 February 23; cited 2010 June 4]. Back and neck care guide, section 5, Footwear. Available from: .
    1. [homepage on the Internet] Merritt, British Columbia, Canada: Nicola Valley Chiropractic; c2001 [cited 2010 June 4]. The downside of the high heels. Available from: .
    1. Apex Chiropractic Los Angeles [homepage on the Internet]. Santa Monica, California: Apex Chiropractic; c2008 [cited 2010 June 4]. Women's health—high heels. Available from: .
    1. Posture & Flexibility [homepage on the Internet]. Canberra, Australia: Posture & Flexibility; [cited 2010 June 4]. The downside of the high heel. Available from: .
    1. [home page on the Internet]. Silver Spring, Maryland: Discovery Communications, LLC; c1998-2009 [cited 2010 June 4]. How to prevent back pain—wear the right shoes. Available from: .
    1. [homepage on the Internet]. Alpharetta, Georgia, USA: BodyZone, LLC; [cited 2010 June 4]. Spinal care do's and don'ts, standing. Available from: .
    1. [homepage on the Internet]. Coventry, West Midlands, England: The Pain Clinic; c2009 [cited 2010 June 4]. Spinal pain, low back pain, posture and lifting. Available from: .
    1. [home page on the Internet]. New York, New York: The New York Times Company; c2009 [updated 2008 June 6; cited 2010 June 4]. High-heeled shoes—bad for the body, fashion at a high price. Available from: .
    1. Bendix T., Sorenson S.S., Klaussen K. Lumbar curve, trunk muscles, and the line of gravity with different heel heights. Spine. 1984;9(2):223–227.
    1. Snow R.E., Williams K.R. High-heeled shoes: their effect on center of mass position, posture, three-dimensional kinematics, rearfoot motion, and ground reaction forces. Arch Phys Med Rehabil. 1994;75(5):568–576.
    1. Opila-Correia K.A. Kinematics of high-heeled gait with consideration for age and experience of wearers. Arch Phys Med Rehabil. 1990;71(11):905–909.
    1. Cowley E.E., Chevalier T.L., Chockalingam N. The effect of heel height on gait and posture: a review of the literature. J Am Podiatr Med Assoc. 2009;99(6):512–518.
    1. Lee C.M., Jeong E.H., Freivalds A. Biomechanical effects of wearing high-heeled shoes. Int J Ind Ergon. 2001;28(6):321–326.
    1. Iunes D.H., Monte-Raso W., Santos C.B.A., Castro F.A., Salgado H.S. Postural influence of high heels among adult women: analysis by computerized photogrammetry. Rev Bras Fisioter. 2008;12(6):454–459.
    1. Ebrahimian M., Ghaffarinejad F. The survey of the effect of heeled shoes on lumbar lordosis and pelvic tilt angles in females 20-30 years old [abstract] In: Vleeming A., Mooney V., Hodges P., Lee D., McGill S., Ostgaard H.C., editors. Proceedings of the 5th Interdisciplinary World Congress on Low back and pelvic pain; Nov. 7-10; Melbourne, Australia. 2004. p. 361.
    1. Yoo J. Hanyang University; Seoul, Korea: 1997. Assessment of lumbar lordosis by skin markers during gait [thesis]
    1. Fedorak C., Ashworth N., Marshal J., Paull H. Reliability of the visual assessment of cervical and lumbar lordosis: how good are we? Spine. 2003;28(16):1857–1859.
    1. Mosner E.A., Bryan J.M., Stull M.A., Shippee R. A comparison of actual and apparent lumbar lordosis in black and white adult females. Spine. 1989;14(3):310–314.
    1. Bryan J.M., Mosner E., Shippee R., Stull M.A. Investigation of the validity of postural evaluation skills in assessing lumbar lordosis using photographs of clothed subjects. J Orthop Sports Phys Ther. 1990;12(1):24–29.
    1. Walsh M., Breen A.C. Reliability and validity of the Metrecom Skeletal Analysis System in the assessment of sagittal plane lumbar angles. Clin Biomech. 1995;10(4):222–223.
    1. Tuzun C., Yorulmaz I., Cindas A., Vatan S. Low back pain and posture. Clin Rheumatol. 1999;18(4):308–312.
    1. Liebig E.M., Kothe R., Mannion A.F., Grob D. The clinical significance of the lumbar lordosis: relationship between lumbar spinal curvature and low back pain [conference abstract] Eur Spine J. 2000;9(4):286.

Source: PubMed

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