Pain and functional disability related to foot and ankle among high heel users: Analytical cross-sectional study

Abstract

Objective: To assess the intensity of pain and functional disability related to the foot and ankle among high-heel users. Methods: A total of 208 female participants aged 18 years or older were included in this analytical cross-sectional study. Participants who met the inclusion criteria and provided informed consent were included in the study. Pain and functional disability were assessed using the Numeric Pain Rating Scale (NPRS) and Foot and Ankle Disability Index (FADI), respectively, and data regarding heel use, including duration and frequency per day and per week, were collected through a structured questionnaire. The data were not normally distributed; therefore, non-parametric tests were applied. Spearman correlation was used for correlation analysis, while multivariate multiple regression was applied to identify independent predictors of pain and functional disability. Results: A total of 208 female participants were included, with a mean age of 24.25 ± 6.39 years and a mean BMI of 22.03 ± 3.25 kg/m2. The mean NPRS score was 4.90 ± 2.21, and the mean FADI score was 83.35 ± 18.27. Pain distribution showed 13.9% with no pain, 29.3% with mild pain, 39.9% with moderate pain, and 16.8% with severe pain. NPRS and FADI scores showed significant variation (p = 0.001 and p = 0.002), while BMI was not significantly associated with either outcome. Multivariate multiple regression analysis demonstrated that age was the only significant independent predictor, with higher pain intensity (β = 0.152, p < 0.001) and lower functional ability (β = -1.106, p < 0.001), whereas BMI and heel-use characteristics showed no significant associations with either outcome. Conclusion: Most participants experienced mild to moderate foot pain, with moderate pain being the most common category. Increasing age was significantly associated with higher pain intensity and greater functional disability, as reflected by higher NPRS scores and lower FADI scores. In contrast, BMI, heel height, and the frequency of daily and weekly heel use were not significantly associated with either outcome. Age was identified as a significant predictor of higher pain intensity and reduced functional ability, whereas heel-use characteristics did not predict either outcome. Level of Evidence III; Analytical Cross-sectional Study