Prevalence and Associated Risk Factors of Foot Pain among Working Females - A Cross-Sectional Study

Foot Pain and Associated Risk Factors



Body Mass Index, Foot Injuries, Pain, Women


Background: Although foot pain in working women is an ongoing problem and may be related to footwear, the prevalence of foot pain in young females is still scarce. Therefore, this study aimed to discover the common cause of foot pain and its possible associated factors (body mass index and shoe heel height) in young working women of Karachi, Pakistan, in an urban setting.

Methods: The survey was conducted on a group of working women aged between 21–40 years who were selected using non-probability convenience sampling. Data on foot problems was collected through an investigator-directed questionnaire using adapted foot questionnaires. The data was analyzed using SPSS version 20.

Results: A total no. of 382 women between the ages of 21 and 40 who worked in various Karachi, Pakistan organizations were included in the study. The study revealed that the majority of these women (n=255) experienced moderate pain, most had average body mass indices (N=192), and most had previously worn shoes with heels higher than one inch (n=199). The prevalence of mild foot pain was 17.53%, moderate foot pain 66.75% and severe foot pain 15.7%.

Conclusion: Non-traumatic foot pain is common among young working women, likely due to high heeled shoes, prolonged working hours, and standing nature of jobs.


Author Biographies

Rabia Asif Khan, Isra University, Karachi Campus

Isra Institute of Rehabilitation Sciences

Fouzia Hussain, Ziauddin University

College of Physical Therapy, Faculty of Allied Health Sciences


Gates LS, Arden NK, Hannan MT, Roddy E, Gill TK, Hill CL, Dufour AB, Rathod‐Mistry T, Thomas MJ, Menz HB, Bowen CJ. Prevalence of foot pain across an international Consortium of Population‐Based cohorts. Arthritis care & research. 2019 May;71(5):661-70.

Fatima S, Riaz U, Sadia A, Khalid M, Jamal A, Ilyas T. Association Between Foot Pain and High Heeled Shoes in Working Women: Association between Foot Pain and High Heeled Shoes. Pakistan BioMedical Journal. 2022 May 31:49-53.

Ebbeling CJ, Hamill J, Crussemeyer JA. Lower extremity mechanics and energy cost of walking in high-heeled shoes. Journal of Orthopaedic & Sports Physical Therapy. 1994 Apr;19(4):190-6.

Chua YP, Tan WJ, Yahya TS, Saw A. Prevalence of nontraumatic foot pain among urban young working women and its contributing factors. Singapore Med J. 2013 Nov 1;54(11):630-3.

Awale A, Dufour AB, Katz P, Menz HB, Hannan MT. Link between foot pain severity and prevalence of depressive symptoms. Arthritis care & research. 2016 Jun;68(6):871-6.

Lambros V. Facial aging: a 54-year, three-dimensional population study. Plastic and reconstructive surgery. 2020 Apr 1;145(4):921-8.

Anderson J, Williams AE, Nester C. Musculoskeletal disorders, foot health and footwear choice in occupations involving prolonged standing. International Journal of Industrial Ergonomics. 2021 Jan 1;81:103079.

Ganesan B, Prasad P, Akter S, Tong RK. Common orthopedic problems in the foot and their implications for footwear design. InHandbook of Footwear Design and Manufacture 2021 Jan 1 (pp. 413-438). Woodhead Publishing.

Tyler TF, Mchugh MP, Mirabella MR, Mullaney MJ, Nicholas SJ. Risk factors for noncontact ankle sprains in high school football players: the role of previous ankle sprains and body mass index. The American journal of sports medicine. 2006 Mar;34(3):471-5.

Stolwijk NM, Louwerens JW, Nienhuis B, Duysens J, Keijsers NL. Plantar pressure with and without custom insoles in patients with common foot complaints. Foot & Ankle International. 2011 Jan;32(1):57-65.

Moayedi M, Arshi AR, Salehi M, Akrami M, Asl NJ, Naemi R. An investigation into the hammer toe effects on the lower extremity mechanics and plantar fascia tension: A case for a vicious cycle and progressive damage. Computers in Biology and Medicine. 2023 Jan 1;152:106381.

Fujii K, Maekawa A, Komoda T, Kawabe N, Nishimura R, Sakakibara Y, Fukumoto T, Stolt M. Foot Problems and Their Associations with Toe Grip Strength and Walking Speed in Community-Dwelling Older Individuals Using Day Services: A Cross-Sectional Study. Nursing Reports. 2023 Apr 13;13(2):697-720.

Dufour AB, Losina E, Menz HB, LaValley MP, Hannan MT. Obesity, foot pain and foot disorders in older men and women. Obesity research & clinical practice. 2017 Jul 1;11(4):445-53.

Laitinen AM, Boström C, Hyytiä S, Stolt M. Experiences of foot health in patients with rheumatoid arthritis: a qualitative study. Disability and Rehabilitation. 2022 Jan 11;44(1):88-95.

Cotchett M, Lennecke A, Medica VG, Whittaker GA, Bonanno DR. The association between pain catastrophising and kinesiophobia with pain and function in people with plantar heel pain. The Foot. 2017 Aug 1;32:8-14.

Zeidan H, Kawagoe M, Kajiwara Y, Harada K, Nishida Y, Yamada K, Kawabe R, Yokota J, Yamashiro C, Odake Y, Takeda M. The shape of the transverse arch in high heels while standing. Plos one. 2020 Jun 8;15(6):e0233958.

Jabbar S, Sabir S, Irum S, Raza H, Wassi A, Subazwari AB. Prevalence of forefoot pain among high heel wearing female teachers and students of different universities in Faisalabad. Health Science Journal. 2020;14(2):1-4.

Jellema AH, Huysmans T, Hartholt K, van der Cammen TJ. Shoe design for older adults: evidence from a systematic review on the elements of optimal footwear. Maturitas. 2019 Sep 1;127:64-81.

Fawzy MS, Alshammari MA, Alruwaili AA, Alanazi RT, Alharbi JA, Almasoud AM, Alshammari RA, Toraih EA. Factors associated with diabetic foot among type 2 diabetes in Northern area of Saudi Arabia: a descriptive study. BMC research notes. 2019 Dec;12:1-7.

Güren HG, Kaygısız BB, Gözgen H. Physical Activity Level and Pain Incidence in Women Wearing High Heeled Shoes. Sports Medicine Journal/Medicina Sportivâ. 2020 Apr 1;16(2).

Irsyam OI, Ketaren AS, Putra RM, Tendean S, Budisantoso AB. Contributing factors to musculoskeletal disorders in women who routinely use high heels. Bali Medical Journal. 2022 Aug 3;11(2):711-4.