In the United States, one in six persons suffers from foot problems. The main reason why so many people have problems ranging from bunions to hammer toes is poor choice of shoes and their improper fit.

"Most of the people who come into my office with pain around the toes are women who have cosmetic concerns about their feet and shoe wear. They don't want to be told that the problems lie in the shoes they wear," says Dr. Charles Saltzman, associate professor of orthopaedic surgery and biomedical engineering at the University of Iowa College of Medicine.

Until the 19th Century, men's shoes resembled women's, but the shape and comfort of men's shoes were improved. The obvious dilemma for women remains that the rectangular shape of the foot does not easily fit into the triangular shape of the foot box in many shoes. In addition, the higher the heel of a woman's dress shoe, the greater the pressure on a relatively small area of the foot.

"As we age, our feet widen and lengthen, yet most people seldom change the size of their shoes," Saltzman says. Improvements are still needed for some women's shoes. "A lot of women around here do not wear damaging shoes all of the time. But in larger, corporate cities you see women wearing the high heel, triangular-shaped style of shoe everywhere," Saltzman says.

Of the more than 43 million people who have foot problems, 36 percent regard their problems serious enough to warrant medical attention.

"Patients need to be aware that after surgery the foot is never quite the same," says Saltzman. "If surgery around the toe is done, patients must then alter the type of shoes they wear or else the foot has a high possibility of going back to the way it was prior to surgery."

A survey by the Council on Women's Shoewear found that women have no foot pain or deformity if they wear dress shoes no more than a quarter-inch narrower than the foot, or sports shoes that are the same width of the foot. In order to determine the width of your foot, stand on a stool to place all the weight on the foot. Then measure the widest part of the foot and compare it to the measurement of the widest part on the bottom of the shoe. If the width is more than a half-inch narrower than the foot, you have a higher chance of developing foot pain or deformities.