High heels in itself are painful to wear (and heels are bad for your feet) but specific foot problems can make wearing heels that much worse. Some women may blame the stiletto for causing their foot pain rather than a structural foot problem that they may have. Getting a handle on the foot problems that don't mix well with heels may help you wear heels more comfortably and avoid that high heel hangover altogether.
Bunions are the most common foot problem associated with high heels. For those of you who don't know, bunions are those unsightly boney prominences on the inside of the big toe. While bunions look like bone growths (they're not), they are actually the result of improper alignment of the big toe joint. Bunions are painful in heels because the shape and position of the shoe press up against the prominent bunion bone -- resulting in direct irritation.
Solution: Get a slim gel bunion sleeve to place over the bunion area to avoid friction. Some shoes can be spot stretched to accommodate your bunion. Toe separators and bunion splints may be useful at night to try and undo any big toe malalignment that heels cause. Bunion surgery to realign the bones is an option for bunions that continue to be painful despite some of these measures. Before considering surgery, you should also read "The Best Products To Avoid Bunion Surgery."
2. Hammer Toes
Crooked and bent toes cause varying friction points within a high heeled shoe resulting in pain, swelling, redness, corns and/or skin sores. A hammer toe forms when the small joints of the toes pop out of alignment and become prominent. Many women mistakenly blame the heel for causing the thickened skin (corns) on their toes, but rather the corn is byproduct of the underlying hammer toe.
Solution: Much of the acute pain with hammer toes and heels involves rubbing of the top of the toes. There are a variety of hammer toe treatment products, though gel pads often work best and can be placed on the toes. A runway model trick is to use bandaids on the toes. Placing thin felt or moleskin on the underside of the shoe toe box can help a lot. If corns are present, be sure to keep them well trimmed and moisturized. Hammer toe surgery involves removing the prominent knuckle bone to prevent ongoing friction.
3. Tailor's Bunions
Tailors bunions (also known as bunionettes) are the smaller bunions on the outside of the foot located by the 5th toe. Tailor's bunions are caused by an abnormally shaped bone. Pressure and friction from high heels and more so a pointy toe shoe will cause the area to become problematic.
Solution: Just like the bunions, tailor's bunion treatment involves providing cushioning and avoiding pressure. Toe spacers and splints are not effective for these smaller bunions. When all else fails, bone shaving can be effective.
4. Pump Bump
The abnormal foot position from heel wearing makes the back of the heel bone prominent, and become a source of irritation against the counter of the shoe. This is so common that the medical community named the condition "pump bumps." Some people genetically have an enlarged heel bone, making the problem that much worse.
Solution: Decrease heel height when you can. Pad the inside counter of the shoe with moleskin. Sometimes a band aid will go along a way at lessening friction. If the bone is enlarged, bone shaving surgery can be performed but this depends on the size and shape of the heel bone.
5. Metatarsalgia (pain in the ball of the foot)
Wearing heels means walking mostly on the ball of the foot and can result in a condition called metatarsalgia, which is inflammation of the these foot bones. As heel height increases so does pressure on the ball of the boot. Some people develop thick calluses on the bottom of the foot that can also be painful. Many people with bunions and hammer toes can develop metatarsalgia as well from abnormal foot biomechanics. Ongoing and significant pain on the ball of the foot can cause stress fractures and ligament ruptures -- leading to permanent foot damage so it should taken seriously and may need professional treatment.
Solution: Absolutely get gel cushions for the forefoot and try to wear high heels with a platform as they tend to provide more cushion. Limit time in high heels and with active pain and swelling you may need a vacation from your high heels. If bunions and hammer toes are present, they can exacerbate metatarsalgia and steps should be taken to manage those structural issues.
Dr. Neal Blitz
Reconstructive Foot & Ankle Surgery
Creator of the Bunionplasty(R) procedure
New York City
To Learn More About Dr. Blitz, visit: www.DrNealBlitz.com