High-heeled shoes and musculoskeletal injuries: a narrative systematic review

Maxwell S. Barnish; Jean Barnish

doi:10.1136/bmjopen-2015-010053

High-heeled shoes and musculoskeletal injuries: a narrative systematic review

Maxwell S. Barnish, Jean Barnish

Research output: Contribution to journal › Article › peer-review

59 Citations (Scopus)

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Abstract

OBJECTIVES: To conduct the first systematic review from an epidemiological perspective regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, osteoarthritis (OA) and both first-party and second-party injury in human participants without prior musculoskeletal conditions.

SETTING: A systematic review of international peer-reviewed scientific literature across seven major languages.

DATA SOURCES: Searches were conducted on seven major bibliographic databases in July 2015 to initially identify all scholarly articles on high-heeled shoes. Supplementary manual searches were conducted. Titles, abstracts and full-text articles were sequentially screened to identify all articles assessing epidemiological evidence regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, OA and both first-party and second-party injury in human participants without prior musculoskeletal conditions. Standardised data extraction and quality assessment (Threats to Validity tool) were conducted.

PRIMARY AND SECONDARY OUTCOME MEASURES: Musculoskeletal pain or OA as assessed by clinical diagnosis or clinical assessment tool. First-party or second-party injury.

RESULTS: 644 unique records were identified, 56 full-text articles were screened and 18 studies included in the review. Four studies assessed the relationship with hallux valgus and three found a significant association. Two studies assessed the association with OA and neither found a significant association. Five studies assessed the association with musculoskeletal pain and three found a significant association. Eight studies assessed first-party injury and seven found evidence of a significant injury toll associated with high-heeled shoes. One study provided data on second-party injury and the injury toll was low.

CONCLUSIONS: High-heeled shoes were shown to be associated with hallux valgus, musculoskeletal pain and first-party injury. No conclusive evidence regarding OA and second-party injury was found. Societal and clinical relevance of these findings is discussed. Concern is expressed about the expectation to wear high-heeled shoes in some work and social situations and access by children.

Original language	English
Article number	e010053
Pages (from-to)	1-8
Number of pages	8
Journal	BMJ Open
Volume	6
Issue number	1
Early online date	13 Jan 2016
DOIs	https://doi.org/10.1136/bmjopen-2015-010053
Publication status	Published - Jan 2016

Bibliographical note

Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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10.1136/bmjopen-2015-010053Licence: CC BY-NC

High-heeled shoes and musculoskeletal injuries: a narrative systematic review
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Final published version, 1.06 MBLicence: CC BY-NC

Cite this

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title = "High-heeled shoes and musculoskeletal injuries: a narrative systematic review",

abstract = "OBJECTIVES: To conduct the first systematic review from an epidemiological perspective regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, osteoarthritis (OA) and both first-party and second-party injury in human participants without prior musculoskeletal conditions.SETTING: A systematic review of international peer-reviewed scientific literature across seven major languages.DATA SOURCES: Searches were conducted on seven major bibliographic databases in July 2015 to initially identify all scholarly articles on high-heeled shoes. Supplementary manual searches were conducted. Titles, abstracts and full-text articles were sequentially screened to identify all articles assessing epidemiological evidence regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, OA and both first-party and second-party injury in human participants without prior musculoskeletal conditions. Standardised data extraction and quality assessment (Threats to Validity tool) were conducted.PRIMARY AND SECONDARY OUTCOME MEASURES: Musculoskeletal pain or OA as assessed by clinical diagnosis or clinical assessment tool. First-party or second-party injury.RESULTS: 644 unique records were identified, 56 full-text articles were screened and 18 studies included in the review. Four studies assessed the relationship with hallux valgus and three found a significant association. Two studies assessed the association with OA and neither found a significant association. Five studies assessed the association with musculoskeletal pain and three found a significant association. Eight studies assessed first-party injury and seven found evidence of a significant injury toll associated with high-heeled shoes. One study provided data on second-party injury and the injury toll was low.CONCLUSIONS: High-heeled shoes were shown to be associated with hallux valgus, musculoskeletal pain and first-party injury. No conclusive evidence regarding OA and second-party injury was found. Societal and clinical relevance of these findings is discussed. Concern is expressed about the expectation to wear high-heeled shoes in some work and social situations and access by children.",

author = "Barnish, {Maxwell S.} and Jean Barnish",

note = "Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.",

year = "2016",

month = jan,

doi = "10.1136/bmjopen-2015-010053",

language = "English",

volume = "6",

pages = "1--8",

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T1 - High-heeled shoes and musculoskeletal injuries

T2 - a narrative systematic review

AU - Barnish, Maxwell S.

AU - Barnish, Jean

N1 - Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

PY - 2016/1

Y1 - 2016/1

N2 - OBJECTIVES: To conduct the first systematic review from an epidemiological perspective regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, osteoarthritis (OA) and both first-party and second-party injury in human participants without prior musculoskeletal conditions.SETTING: A systematic review of international peer-reviewed scientific literature across seven major languages.DATA SOURCES: Searches were conducted on seven major bibliographic databases in July 2015 to initially identify all scholarly articles on high-heeled shoes. Supplementary manual searches were conducted. Titles, abstracts and full-text articles were sequentially screened to identify all articles assessing epidemiological evidence regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, OA and both first-party and second-party injury in human participants without prior musculoskeletal conditions. Standardised data extraction and quality assessment (Threats to Validity tool) were conducted.PRIMARY AND SECONDARY OUTCOME MEASURES: Musculoskeletal pain or OA as assessed by clinical diagnosis or clinical assessment tool. First-party or second-party injury.RESULTS: 644 unique records were identified, 56 full-text articles were screened and 18 studies included in the review. Four studies assessed the relationship with hallux valgus and three found a significant association. Two studies assessed the association with OA and neither found a significant association. Five studies assessed the association with musculoskeletal pain and three found a significant association. Eight studies assessed first-party injury and seven found evidence of a significant injury toll associated with high-heeled shoes. One study provided data on second-party injury and the injury toll was low.CONCLUSIONS: High-heeled shoes were shown to be associated with hallux valgus, musculoskeletal pain and first-party injury. No conclusive evidence regarding OA and second-party injury was found. Societal and clinical relevance of these findings is discussed. Concern is expressed about the expectation to wear high-heeled shoes in some work and social situations and access by children.

AB - OBJECTIVES: To conduct the first systematic review from an epidemiological perspective regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, osteoarthritis (OA) and both first-party and second-party injury in human participants without prior musculoskeletal conditions.SETTING: A systematic review of international peer-reviewed scientific literature across seven major languages.DATA SOURCES: Searches were conducted on seven major bibliographic databases in July 2015 to initially identify all scholarly articles on high-heeled shoes. Supplementary manual searches were conducted. Titles, abstracts and full-text articles were sequentially screened to identify all articles assessing epidemiological evidence regarding the association between high-heeled shoe wear and hallux valgus, musculoskeletal pain, OA and both first-party and second-party injury in human participants without prior musculoskeletal conditions. Standardised data extraction and quality assessment (Threats to Validity tool) were conducted.PRIMARY AND SECONDARY OUTCOME MEASURES: Musculoskeletal pain or OA as assessed by clinical diagnosis or clinical assessment tool. First-party or second-party injury.RESULTS: 644 unique records were identified, 56 full-text articles were screened and 18 studies included in the review. Four studies assessed the relationship with hallux valgus and three found a significant association. Two studies assessed the association with OA and neither found a significant association. Five studies assessed the association with musculoskeletal pain and three found a significant association. Eight studies assessed first-party injury and seven found evidence of a significant injury toll associated with high-heeled shoes. One study provided data on second-party injury and the injury toll was low.CONCLUSIONS: High-heeled shoes were shown to be associated with hallux valgus, musculoskeletal pain and first-party injury. No conclusive evidence regarding OA and second-party injury was found. Societal and clinical relevance of these findings is discussed. Concern is expressed about the expectation to wear high-heeled shoes in some work and social situations and access by children.

U2 - 10.1136/bmjopen-2015-010053

DO - 10.1136/bmjopen-2015-010053

M3 - Article

C2 - 26769789

SN - 2044-6055

VL - 6

SP - 1

EP - 8

JO - BMJ Open

JF - BMJ Open

IS - 1

M1 - e010053

ER -

High-heeled shoes and musculoskeletal injuries: a narrative systematic review

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