High Heels May Not Cause Knee Arthritis

Weight, Not Cruel Shoes, Linked to Knee Arthritis

From the WebMD Archives

"Well, we have the cruel shoes, but no one would want ..."
Anna interrupted, "Oh yes, let me see the cruel shoes!

-- Steve Martin, "Cruel Shoes"

Sept. 29, 2003 -- High-heeled shoes may be cruel to your feet, but they aren't likely to give you knee arthritis.

That's what Jill Dawson, PhD, and colleagues at Oxford Brookes University, Oxford, England, report in the October issue of the Journal of Epidemiology and Community Health.

Why study high heels? There's evidence linking knee osteoarthritis -- the breakdown of cartilage in the knee -- to physical stress on the knee joint. It's more common in women than in men. That has led to speculation that high heels are to blame.

So Dawson's team decided to take a look. They interviewed 29 women awaiting knee replacement surgery for knee osteoarthritis. All suffered at least moderate knee pain on most days. The researchers also interviewed 82 women with no knee pain living in the same area. All study participants were 50 to 70 years old.

The interviewers asked questions that detailed the women's life histories. They included questions about when the women first wore high heels; whether they wore them dancing, at work, or at social events; and how many years they wore heels that were one, two, or three inches high.

The surprising finding: Wearing high-heels -- especially dancing in three-inch heels -- had a slight protective effect against knee arthritis. That's no reason to start wearing cruel shoes. But the finding does make it unlikely that high heels are to blame for knee arthritis.

It wasn't a very large study, so it's possible that Dawson's team missed something.

"It therefore remains possible, although unlikely, that a larger study could find a relation between wearing high heels and increased risk of knee osteoarthritis," they write. "That is, we would not expect a large study to overturn the direction of this study's findings."

So what does cause knee arthritis? Dawson's team found a clue. Women who became overweight before age 40 were much more likely to need knee replacement. The British researchers now will pursue this clue, and are planning to put their high-heel research back in motion.

SOURCE: Dawson, J. Journal of Epidemiology and Community Health, October 2003; vol 57: pp 823-830.