High Heels and Ball of Foot Pain: What You Need to Know

If your high heels are leaving you with pain in the balls of your feet, you're not alone. It's very common for shoes with elevated heels to be the direct cause of or a contributing factor in ball of foot pain. Metatarsalgia, the medical term for pain and inflammation in the ball of the foot, is one of the primary causes of foot pain. It's important to understand how footwear (and more specifically high heels) plays a role in ball of foot pain and what you can do about it. 

When you wear high heels, your body weight shifts forward and this puts additional pressure on the forefoot. Oftentimes, it's more pressure than the forefoot can handle. If you only wear your heels for small amounts of time, your feet may be able to adjust to the pressure and remain pain-free. However, if you wear your heels for more time, the continuous pressure can lead to pain.

Some high heel shoe styles also crowd the toes, squeezing them into a tight space. This is especially problematic with heels that have a pointy toe. This compression effect can also contribute to pain in the ball of the foot. In high heels lack adequate padding, leaving the forefoot suffering from painful impacts with every step.

Yes, high heels can cause ball of foot pain in some people. While there is no guarantee that high heels will lead to pain in all cases, shoes with an elevated heel are a very common cause of pain in the ball of the foot.

Older people are especially vulnerable to ball of foot pain from wearing high heels. This is because over time, the natural fat pad underneath the ball of the foot thins. With less protection against pressure and impacts, the area can become painful and inflamed.

High heels are not the only types of shoes that can contribute to ball of foot pain. Ill-fitted shoes that don't have sufficient cushioning, crowd the toes, or are too tight or too loose, can also increase the risk of ball of foot pain.

Not all high heels are alike. Some shoe styles are much more problematic than others. If you’re not ready to ditch the heels entirely, there are ways to reduce your risk of developing ball of foot pain.

Consider the following when shopping for high heels:

• Heel height: The higher the heel, the more likely you are to suffer from ball of foot pain. Keep the heel height as low as you can, staying under two inches.
• Toe box shape: Narrow or pointed toe boxes compress the toes and forefoot, increasing pressure on the balls of the feet. Look for a shoe style with a wide toe box or an open toe design.
• Heel thickness: Shoes with a thicker heel provide better stability. Wider heels are also more effective at distributing weight more evenly so that it’s not concentrated in the ball of the foot. Look for shoes that have a wider heel, such as a wedge-style shoe. Try to avoid shoes with a slim, narrow heel, like stilettos.
• Shoe fit: When you wear your high heels, your feet should feel snug but not crowded in the shoe. If your feet feel like they’re being squeezed or crowded, you’re more likely to develop ball of foot pain. This is also the case for shoes that slip and slide around. Your foot should feel secure and stay in place when you walk.
• Cushioning and support: Many styles of high heels have little support or padding, making them especially hard on the feet. However, there are comfort styles of high heels available. Look for options that have extra cushioning to take pressure off the ball of foot and protect against ground strikes.

Some people struggle with foot discomfort more than others when wearing high heels. There are individuals who are able to wear high heels and remain pain-free. Others find that wearing heels, even in moderation, is unbearable. Because everyone is different, there's no exact formula for determining if someone will develop foot pain from wearing heels.

Certain types of foot issues and deformities can make it more likely for someone to experience discomfort from wearing heels. These include:

• Bunions
• Corns
• Hammertoe
• Osteoarthritis
• Plantar fasciitis

Wearing heels for long durations without taking breaks can also increase the risk of foot pain. Some people are able to manage their pain by limiting the amount of time in heels and taking regular breaks. Wearing heels occasionally for special events may not cause problems in most people, but daily wear is much more likely to cause issues. Some people experience a cumulative effect with pain worsening the longer they wear the heels.

Some people just can’t give up their high heels entirely. If you choose to continue wearing problematic footwear, there are ways of managing pain associated with heels.

• Heel width and height: Choose a lower or more stable heel when possible: The lower and wider the heel is, the less likely it is to cause trouble. Choose a style that’s lower than two inches and has a wide heel for better stability.
• Roomy toe box: Select shoes with adequate room in the toe box. Make sure your shoes don’t crowd or compress your toes into a tight space. Your toes should have ample room to move. Avoid pointy toe styles.
• Set time limits: Try not to wear your high heels often or for long periods. Give your feet breaks by sitting regularly.
• Use shoe inserts: Try cushioned shoe inserts for added comfort. Dr. Scholl's® Love Your Heels & Wedges 3/4 Length Insoles are designed to direct pressure away from the ball of the foot, making high heels easier to wear. The insoles also help keep the feet in place, preventing them from sliding forward. The slim, clear profile is very discreet, making the insoles practically invisible.
• Switch out your footwear. If you love wearing high heels with certain outfits, make sure you have other types of comfortable footwear for days when you’re dressed more casually.

If you love wearing heels, it’s important to understand that they increase the risk of common problems, including ball of foot pain. While you may not have to give them up entirely, it’s best to take precautions by adopting smart strategies for avoiding pain. If you do develop pain, give your feet a break and give up the heels until the discomfort resolves. See your healthcare provider if the pain doesn’t improve or it gets worse.

• https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790
• https://www.health.harvard.edu/pain/plantar-fasciitis-symptoms-causes-and-treatments
• https://www.health.harvard.edu/diseases-and-conditions/the-heel-problem-that-threatens-your-mobility
• https://my.clevelandclinic.org/health/diseases/17038-hammertoes
• https://www.uclahealth.org/news/article/fat-pad-atrophy-can-cause-painful-stress-feet
• https://pubmed.ncbi.nlm.nih.gov/38654097/
• https://pubmed.ncbi.nlm.nih.gov/37081521/
• https://pmc.ncbi.nlm.nih.gov/articles/PMC8720874/
• https://pmc.ncbi.nlm.nih.gov/articles/PMC6047962/
• https://pubmed.ncbi.nlm.nih.gov/20675640/

Sources:

https://pubmed.ncbi.nlm.nih.gov/38654097/

https://pubmed.ncbi.nlm.nih.gov/37081521/

https://pmc.ncbi.nlm.nih.gov/articles/PMC8720874/

https://www.drscholls.com/pages/symptoms-and-conditions-ball-of-foot-pain

https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790

https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846

https://www.health.harvard.edu/pain/plantar-fasciitis-symptoms-causes-and-treatments

https://www.health.harvard.edu/diseases-and-conditions/the-heel-problem-that-threatens-your-mobility

https://my.clevelandclinic.org/health/diseases/17038-hammertoes

https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790

https://pubmed.ncbi.nlm.nih.gov/20675640/

https://www.uclahealth.org/news/article/fat-pad-atrophy-can-cause-painful-stress-feet

https://pmc.ncbi.nlm.nih.gov/articles/PMC6047962/

https://pmc.ncbi.nlm.nih.gov/articles/PMC11039660/