High fashion, or high risk? The effects of high heels on your spine

High heel hazards (and how to minimize them)

  • High heels can accelerate damage to your spine over time
  • Good posture is essential for spine health, but impossible to maintain in high heels
  • Wearing high heels less frequently and choosing a shorter heel can help
  • Maintaining additional healthy habits can help protect your spine for life


Sky-high stilettos and pointy-toe pumps have been giving way to more sensible footwear in the fashion world. Serena Williams wore a pair of bedazzled Nikes to her own wedding, and jewel-encrusted flats have been gracing the red carpet for the past several years. And that’s a good thing—for celebrities, fashionistas and anyone else who cares about their spine health. Because as sophisticated as a pair of heels may look at work or a special event, they can wreak havoc on your posture and, over time, lead to degenerative spine disease. Which isn’t a good look on anyone.

High heels, poor posture and you

To understand how wearing high heels affects your spine, let’s review what correct posture is and why it’s important. According to the American Chiropractic Association, posture is the position in which we hold our bodies while standing, sitting or lying down. Correct posture allows your muscles and ligaments to support your spine and skeleton, while poor posture can lead to back pain, shoulder pain, headaches and extra pressure and joint degeneration.

"(With heels) your center of gravity shifts, and that strains your neck and lower spine, putting undue pressure on the rest of your body, including your hips, knees, ankles and feet."

When you are standing, your ears, shoulders, hips and knees should be in alignment. If you’re wearing high heels, that alignment is almost impossible to maintain, says Walavan Sivakumar (Dr. Wally) Walavan (Wally) Sivakumar, MD, a neurosurgeon and the Director of Neurosurgery at Providence Little Company of Mary in Torrance, CA. “High heels throw off your body’s natural alignment by pushing your chest and lower back forward—it’s like you are walking up a ramp all day,” explains Dr. Sivakumar, works with the Pacific Neuroscience Institute. “Your center of gravity shifts, and that strains your neck and lower spine, putting undue pressure on the rest of your body, including your hips, knees, ankles and feet.”

How heels hurt your spine

Even if your back doesn’t ache when you are wearing high heels, degenerative changes are likely happening. Eventually you may develop conditions such as:

  • Spinal stenosis, in which the spaces within your spine become more narrow
  • Foraminal stenosis, in which the openings between the bones in your spine narrow
  • Spondylolisthesis, in which one vertebra slips forward onto the bone directly beneath it, leading to spine compression

“Degenerative spine disease can sneak up on you, and after a certain point it is more challenging to treat,” Dr. Sivakumar says. Treatments range from over-the-counter painkillers, physical therapy and steroid injections to surgical repairs.

Reducing your risk for spine damage

If you’re starting to feel stressed about the prospect of throwing all your fancy heels in the trash, take heart! Here are a few tips Dr. Wally shares with his patients that you can use to reduce your risk (while still wearing your favorite heels occasionally).

  • Stretch out your calf muscles before and after wearing heels. This can keep your tendons and muscles loose and prevent pain in your back, legs and feet.
  • Instead of wearing high heels for an entire day or special event, bring along more sensible shoes to give yourself a break.
  • Consider buying heels that are a half shoe size larger than your other shoes for extra wiggle room. Since your legs and feet tend to swell during the day, shop for heels in the afternoon or evening.
  • Aim for a heel of two inches or shorter. Higher heels increase pressure on your entire foot.
  • Avoid pointed toe shoes and stilettoes. Instead, opt for a rounder toe, chunkier heel or wedge. Just because actress Selma Hayek wore 6-inch heels to the 2020 Oscars doesn’t mean you have to!

More strategies to keep your spine in good working order

Wearing high heels isn’t the only factor that contributes to degenerative spine disease. In fact, even people with good posture will experience a certain degree of degenerative spine disease as they age. But wearing heels can certainly accelerate the process. So can:

  • Sitting a lot throughout the day and sedentary lifestyle. Consider using an adjustable-height desk that allows you to sit or stand while you work, and be sure to get up and move around at least once an hour.
  • Being overweight. Extra pounds put added strain on your joints and ligaments.
  • Having weak core muscles. Strength training, yoga and Pilates classes can tone those muscles and help keep your body in alignment.

Even people with good posture will experience a certain degree of degenerative spine disease as they age. But wearing heels can certainly accelerate the process.

An ounce of prevention

“Many people don’t worry about their spine health until they start to develop neck or back pain, but that’s a mistake,” Dr. Sivakumar says. “I encourage patients to be mindful of their posture throughout the day and be as physically fit as they can—these are healthy habits that may help delay degenerative spine disease indefinitely.”


Find a doctor

If you are concerned about symptoms related to your spine health, a Providence spine specialist can help. You can find one in our provider directory. Or, you can search for a primary care doctor in your area.






Have you found shoes that are a stylish alternative to high heels? Share a photo at #fabulousfootwear@psjh

Learn more about spine related conditions and the latest news on neurosurgery from Dr. Sivakimar @DrWallyMD and DrWallyMD on Instagram.


Regional resources

California: Spine Care

Texas: Covenant Health Neuroscience Institute 

Washington: Primary Care Providers


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This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

About the Author

Neuroscience is super complex, and the Providence Brain & Spine Team taps into the many decades of expertise to provide useful and helpful advice and tips on non-surgical and surgical options to treat any disease of the mind.

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