Killer Heels: What Your Favorite Shoes Are Doing to Your Feet

More Possible Problems

Problem: Plantar fasciitis
What It Is: Inflammation of the fibrous tissue that connects the heel bone to the metatarsal bones on the bottom of the foot. Symptoms can include a burning sensation and aching on the soles, and dull or sharp heel pain. "If, first thing in the morning, your heel is really painful, and then as you walk around it feels better, that is the classic sign," says Sheryl Strich, DPM, president of the American Association for Women Podiatrists.
Shoe Culprit: Surprise: "High heels are not the evildoer," says Dr. Strich. The most likely culprits are pancake-soled shoes with zero arch support, such as flip-flops, ballet flats, and some casual sneakers. And standing for long periods of time in any shoe -- say, if you work on your feet -- can also cause this common injury.
The Fix: Rest, ice, specific stretching exercises, oral anti-inflammatories, and supportive shoes usually do the trick. If not, your doctor may use steroid injections to ease inflammation and a boot cast or night splints over several weeks to gently stretch the tight tissue. She may also take an impression for custom orthotics to maintain your correct foot position.
Prevention: If you stand a lot or have either flat or high arches, special custom orthotic shoe inserts can help you avoid plantar fasciitis.

Problem: Haglund's deformity
What It Is: Commonly known as "pump bump," it's a bone spur that develops at the back of your heel, where the Achilles tendon attaches. The protruding bone irritates the bursa -- a small, fluid-filled cushion between the tendon and the bone -- leading to a painful condition known as bursitis at the back of the heel.
Shoe Culprit: It's not just your pumps -- any shoe with an overly stiff heel counter (cobbler-speak for the back of the shoe) can dig into that tender area and result in a bony overgrowth. Shoes that are too short make it worse. Genetics also play a role; high arches or a prominent heel bone can make you more prone to pump bump.
The Fix: Rest, ice, and ibuprofen or aspirin can help, as can sticking to backless styles, like clogs, while you heal. In more serious cases, steroid injections or physical therapy can ease inflammation. Surgery can also permanently reduce the size of the heel bone so it's less prone to rubbing.
Prevention: Again, be sure you're wearing the correct length shoe. When you try on both shoes at the store, pay attention to the heel counters: If they're already digging into you, the problem is only going to get worse when you wear them on the street.