It’s the most wonderful time of the year — for everything but your feet.

If your holiday party schedule is nonstop, you may be spending more time than usual wearing high heels.

But stilettos impact your body more than just having sore feet at the end of the night. With constant wear, they may actually cause chronic back pain and strain the knees, thighs and hips.

High heels alter your posture from the bottom up. The height of the heel shifts the body forward, applying pressure to the balls of the feet and causing a series of shifts in the joints necessary for the wearer to stay upright.

High heels also move the center of gravity in the body, shifting it forward. This change requires the wearer to expend more energy to remain stable and balanced, and to adjust her alignment.

High heels cause back pain primarily because muscles and joints are closely connected throughout your body. Think of that children’s song: The plantar fascia, or the ligament that connects the heel bone to the toes, is connected to the calf muscle, which connects to the hamstring. The hamstrings are in turn attached to the lower back and pelvis, meaning any shift or tilt in the plantar fascia of the feet can eventually cause an ache there.

There may be long-term effects as well: A study found that high-heel wearers showed increased curving in the spine and pelvic tilt.

But the negative effects don’t end at the spine. Wearing high heels can lead to knee issues, too. When your heel is lifted up, the rest of your body (and its weight) consequently tilts forward. As a result, your thigh muscles have to work harder in order to keep your knees straight.

It’s this subtle, lower-body shift that can eventually cause knee pain. High heels also can prevent the tendons and muscles in the legs from propelling the body forward as powerfully as they typically would, so the knees, thighs, hips and even the buttocks have to work harder to make up for this loss.

Still, it’s not as though you have to wear running shoes to your holiday parties. If you’ve noticed chronic pain both in your back and elsewhere — and habitually wear high heels — consider seeing a specialist to get to the root of the problem and find a solution.

“An orthopaedic doctor provides insight into what specific behavior is behind your issue, then makes suggests to resolve the problem,” said Eric Tan, MD, assistant professor of clinical orthopaedic surgery and a foot and ankle expert at the USC Department of Orthopaedic Surgery at Keck Medicine of USC. “This can include shoe inserts designed to correct your specific foot issue.”

Stretching and strength training also may boost the muscles around the knee, which can help to minimize damage to your lower-body joints. But the most effective solution might just be the most obvious one: investing in a good pair of flats for the holiday season.

By Deanna Pai

If you suffer from foot, heel or back pain, make an appointment with one of our orthopaedic or spine specialists. To schedule an appointment, call<a href=”tel:8008722273″>(800) USC-CARE (800-872-2273)</a> or visit keckmedicine.org/request-an-appointment.