Are high heels bad for my health?

Dear Doc,

I love wearing high heels. Could they be ruining my health?

Dear reader,
Wearing high heels impairs stability and affects posture and gait. 

It also increases the risk of injury and places mechanical stress on the back. 

The foot itself may develop bunions or calluses, hammertoe and other structural challenges, and you may develop foot or leg pain. 

Even a person who is experienced in wearing heels still has challenges brought on by the excessive pressure on the forefoot, the ankle, the hips, the knees and the back due to the shift in the centre of gravity, the abnormal stride and the struggle balance. It is best to reserve heels for special/rare occasions, or wear them for only a few hours a day while taking breaks in between to stretch the feet. For everyday shoes, the flat or low heels (less than one and a half inch) with good insoles and arch support are best.

Hello Dr Flo,
I appreciate the work you do to inform and help the public to make informed choices about health...it's exemplary work. 
I really need your help. I have been experiencing sharp pain on my back. Sometimes I feel too much pain when I breathe on the left side of my ribs. The pain increases every morning after waking up. I have been to Kiambu Level 5 Hospital, where I was advised to undergo an x-ray and have my blood tested. The blood results came back negative but the x-ray showed something was off. I was told it was bronchitis. I was given a prescription for medicines to buy and I took them to the very end. Pain seemed to disappear but it resurfaced after some time. I went to Mbagathi Hospital having not been satisfied with the care I was given at Kiambu Hospital. I was sent to the lab for a blood test and the results were negative.  The doctor saw my x-ray and concluded that it was bronchitis. He said my prescribed dosage at Kiambu Hospital was not enough and prescribed the correct dosage . But the pain resurfaced once again. 
I went to a private clinic and was treated for cold. But I am still in so much pain. I have given up. I no longer trust our health systems. I don't know what to do now. I feel lost, I am in pain and financially drained. Please help me out.

Dear Reader,
The chest has many components including the heart, the lungs and pleura (lining of the lung), a part of the oesophagus, muscle, bones, cartilage, nerves and blood vessels — the chest pain can arise from a problem with any of them.

Based on your symptoms, you may have a problem with the lungs, the lining of the lungs, the muscles, the bones or the nerves. It would be advisable for you to be seen by an internal medicine specialist/physician so that the exact cause of the pain is identified, then you can be referred to a sub-specialist if need be. You can utilise the National Hospital Insurance Fund card to access care, including, if needed, a CT scan of the chest.
The lungs and the pleura – inflammation of the lung and/or pleura may be caused by infection or by irritants like chemicals and dust. 

An infection will cause significant pain, cough, fast breathing or difficulty in breathing and fever.
 If an infection is present, symptoms usually worsen over time if there is no treatment or if there is inadequate treatment and the symptoms do not disappear on their own. Inflammation caused by irritants and cold, however, may come and go depending on exposure.

Avoiding the trigger will prevent the pain. Medication can also be prescribed to manage the irritation and the pain. Sometimes infection or inflammation may cause damage to the tissues, leading to persistent pain.

The muscles – in between the ribs, there are actually three layers of muscles known as the intercostal muscles. 
There are also many other muscles on the front and back of the chest and along the spine. Any of these muscles could ache, what is called myalgia (muscle pain), either due to recurrent strain, repetitive activity or even from muscle cramps. Usually after some rest, this pain goes away on its own or you may require painkillers and muscle relaxants.

The nerves – there are many nerves running within and across the chest wall. 
Any of them could get “trapped” or damaged, leading to chest pain. This is usually much more difficult to diagnose, but the treatment is medications for pain, and usually the pain goes away with time. If a number of nerves are involved, however, an MRI may need to be done to determine the exact source of the problem for appropriate intervention.

The bones (and cartilage) – there is cartilage that connects the ribs and the sternum (the breast bone). In some cases, there is inflammation between the cartilage and the bone (either the ribs or the sternum). This is called costochondritis. The pain is usually on the left side of the chest, and it may be sharp, or aching, or feel like pressure. The pain is usually worse when you take a deep breath, when you cough or with physical activity, and it usually affects more than one rib. It has no clear cause though it may be triggered by injury, physical strain, or arthritis. Less likely causes include infection or tumours in the joint. Treatment includes pain medication, physiotherapy with stretching and nerve stimulation exercises (TENS), hot or cold compresses and rest. The pain improves on its own after several days or weeks, but sometimes will recur after several months.

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