Manolo Blahnik, Christain Louboutin and Jimmy Choo may be celebrated as the High Priests of Fashion Footwear, but to some they are known as the Patron Saints of Chiropractory.

Too often, the price paid for teetering sexily atop too high a heel is even greater than the exorbitant cost of the shoe. Don’t get us wrong, we love fashion, and we love high heeled shoes, but for spine’s sake, wear them sparingly. The shock waves sent up legs to the pelvis and lower back when high heels strike hard surfaces can damage vertebra as well as strain lower back muscles. According to Dr. Jason Gordon, a back specialist in New York City, the trouble begins at the ankle. “Whenever you’re on a sloped foundation, that’s going to throw your ankle joints off which will then transfer pressure to the knees, then up to the hips, through the lower back and mid-back, all the way to the neck.

The entire skeleton is angled forward, causing the torso to tilt forward. The reason you never see women jutting forward when they wear heels is because their back muscles are contracting to whatever degree is necessary to keep them upright.” Although many women resolutely refuse to acknowledge their sartorial suffering, muscles and nerves don’t know from fashion. “Over time,” says Gordon, “the stress and strain on the lower back muscles can cause serious, on-going problems.”