Heels - How many women wear heels on a regular basis?

Regular tight shoes put pressure on nerves and even damage them, and also contribute in the long run to arthritis, doctors say. Shoes with pointed toes or stiff soles, like the leather versions common in many high-quality shoes, can impede the foot's mechanical function by limiting toe and ankle flexibility, said Dr. Thomas Novella, who practices podiatric medicine in Manhattan and counts many professional dancers and athletes as well as leisure-time runners among his patients.

"Metatarsal pads or stiff shoes inhibit the toes' range of motion and can make you lose toe strength," Dr. Novella said. "You are cheated of the power of your toes, those little muscular soldiers lined up in your feet that are there to help carry you forward."

Dr. Novella said inflexible toe beds were one of the most common causes of shin splints. "If you can't push off with your toes, you begin to pull up or grip with them," he said. Because tendons in the toes attach to the tibia, when the toes tug, it can register in the shins.

Tight shoes also can produce foot deformities in the toes, and can lead to symptoms from deformities that might otherwise go unnoticed, said Dr. Gary Jolly, president of the American College of Foot and Ankle Surgeons, who practices in Hartford. People have a genetic predisposition toward bunions and hammer toe deformities, he said, but shoes are often the factor that turn conditions into problems.

"Almost all bunion surgeries are done on women," he said, adding that because men's shoes normally fit the natural contours of the foot and have plenty of space inside, men may have bunions but no pain.

"I don't remember the last time I did a bunion surgery on a man," Dr. Jolly said.

I only wear them in bed.