Are heels hazardous??

Q: "I'm a 27 year old female and have been having pain at my right big toe joint for 3 days. I do wear heels on a regular basis (but never had this problem before), and am wondering if my shoes are responsible for this. Thoughts?"

A:  You'll have many sympathizers on this one- it's unfortunate the price we may have to pay for our Louboutin-prone decisions.  But yes, indeed, the pain you highlight may be related to your use of high heels. The bad news is that with continued wearing of heels, the symptoms will only get worse and more widespread. The good news is that we have the capacity to do something about it.
Women suffer four times the number of foot problems as men, which in large part may be a result of the footwear we choose. High heel use has been associated with calluses, corns, bunions, arthritis, chronic knee pain, back problems, toe pain and deformity, and poor posture. Heels distort the natural distribution of weight on the foot and ankle, placing the bulk of weight on the forefoot. This increased force on the forefoot causes the entire body to compensate, leading to conditions like knee arthritis. Additionally, this shift in dynamic can lead to loss of arch integrity, causing great toe pain and distortion.
So here are some tips: 1. Limit heel wearing to heels 1.5" or shorter, and no more than 3x/week. 2. Add a metatarsal foam/gel pad to provide cushion and increase shock absorption. 3. Stretch foot/calf muscles after use. 4. Pay attention to your feet (like you've done)!- callous formation or great toe joint pain may be the first sign of loss of arch integrity. 5. For foot stability, choose a wider heel rather than a stiletto. (But be aware that wider heels have been shown to be just as harmful to the knee joint as narrower ones.) 6. For ideal comfort, choose walking or running shoes with good arch support and stability. (Flat shoes and sandals come with their own set of problems and are not a solution to your foot pain.)
Maybe we should take advice from the power-suited Wall Street women of the 1980's- wear your sneakers to work.