They come in all sizes, all colors, all styles and all types — and women of all ages can’t get enough of them. The popularity of high heels has never been higher, and many women enjoy the shoe both at work and for fun.

But sometimes the overuse of high heels can cause major health problems and women are going to the extreme — even receiving Botox injections — to help ease that pain.

Dr. Gerard Cush, foot and ankle orthopedic surgeon at Geisinger Medical Center, said he often performs foot and ankle orthopedics because wearing a higher heel can cause multiple problems in the foot and ankle region.

“Women love high heel shoes because of fashion and some find them comfortable,” he said, but “sometimes there are problems.”

Problems include bunions and hammer toes, the narrowing of the foot resulting from squeezing and often complications with toe nails due to pressure.

Metatarsalgia is also a common condition, where individuals experience pain under the metatarsal heads, or the ball of the foot.

“It’s an area that gets significant increase of pressure, pain and wearing away of the fat pad on the ball of the foot,” he said.

Aside from foot issues, Cush said low back pain and strain can also happen, stemming from balance of the body and strain on the back muscles.

Women should become aware of a possible problem at the onset of pain. “Usually pain brings people aware of the actual problem the shoes are causing; occasionally redness or irritation, calluses or ulcerations,” he said.

Special occasions are reasonable for the shoes especially if there is no pain, he added, however if discomfort develops, people should “lay off for a while” or curb the use and limit it until the pain gets better.

Nonetheless, people frequently find they are not able to get back to those shoes once they begin having problems with their feet.

“Certainly if they’re having pain with using the shoes they need to stop using them until the pain is better. After ceasing, if pain continues then that’s certainly something you should notify your physician about and get a referral to an orthopedist. Sometimes pain can continue and give more problems in the future, both non-operatively and operatively.”

Injecting relief

The thought of giving up the popular shoe, however, is not an option for some women who are going to the extreme of receiving injections to ease the pain they encounter.