Research on Hyaluronic Acid Injections for High Heel Pain
Understanding High Heel Discomfort
Wearing high-heeled shoes can lead to significant discomfort for many individuals, with some experiencing persistent pain over time. This discomfort is often localized to the ball of the foot, where the phalanges (toe bones) meet the metatarsal bones. This condition is known as metatarsalgia, which can arise from various causes, including the regular use of high heels. High-heeled footwear increases pressure on the ball of the foot and can degrade the natural cushioning provided by the fat pad in that area.
Conventional Treatment Approaches
Medical recommendations typically advise individuals to cease wearing high-heeled shoes to alleviate high heel pain. However, this suggestion may not be feasible for everyone, prompting researchers to explore alternative treatments. Previous studies have utilized silicone injections in the ball of the foot for approximately 1,500 patients experiencing high heel pain, yielding positive outcomes. Despite this, silicone implants lack FDA approval for this application due to their permanence and potential complications.
Comparing Hyaluronic Acid and Silicone Injections
Study Design and Objectives
Researchers from a French company specializing in hyaluronic acid developed a study to determine the efficacy of this substance as a cushioning agent for high heel pain. Unlike silicone, hyaluronic acid is a naturally occurring substance in the body that can be broken down metabolically. Although the specific hyaluronic acid used in this investigation is not FDA approved, the researchers noted that a similar FDA-approved variant is available from their company.
Study Results
Published in Dermatologic Surgery, the study involved 14 women who had experienced high heel pain for an average duration of nine years. Each participant received injections of hyaluronic acid combined with a short-acting local anesthetic to minimize injection discomfort. Over six months, the women assessed their pain levels on a scale from 0 to 10.
The findings revealed that approximately one-third of the participants reported complete relief from high heel pain after six months. Those who continued to experience discomfort were able to wear high heels for extended periods before onset of pain and reported that it took longer for the pain to become intolerable. Notably, no adverse reactions occurred among the participants, with half experiencing minimal pain during the injection and the other half reporting no pain at all.
Limitations of the Study
Several limitations must be considered when interpreting these results. First, it remains unclear whether the participants’ metatarsalgia was solely due to high heel usage or if other factors contributed. If other causes were involved, the effectiveness of the treatment could be overstated. Additionally, it is uncertain if the frequency of high heel use changed post-treatment, which may also influence the results.
A critical limitation is the absence of a placebo group in the study. Placebo control is essential in clinical trials to determine whether improvements are attributable to the treatment or merely the psychological impact of believing one has received effective care.
Conclusion
The study’s findings indicate that hyaluronic acid injections in the ball of the foot can provide long-lasting relief from high heel pain without adverse effects. This research introduces a promising non-surgical treatment option for individuals suffering from high heel-related discomfort.
Written by Nicola Cribb, VetMB DVSc Dip.ACVS
Reference: Foumenteze J, Simpson H, Kerrouche N. Hyaluronic Acid Filler Injections Under the Metatarsal Heads Provide a Significant and Long-Lasting Improvement in Metatarsalgia From Wearing High-Heeled Shoes. Dermatol Surg 2018; Publish Ahead of Print: 1.