Twenty-something friends Kris Rosa and Carmen Berry were lunching in midtown Sacramento on a blazing hot workday when, naturally, the subject of shoes popped up.

"Why do you wear those?" Berry asked.

Rosa, a Capitol lobbyist, was wearing a blue business suit with 2-inch black high heels; Berry, who works from home, was dressed in shorts, blouse and flip flops.

"It sometimes has to do with attitude," Rosa said, smiling. "This is the time of year when lobbyists are making noise. I like wearing the heels so (politicians) can hear me coming down the hall. It either warns them or makes them afraid of me."

Yet, there's a price to pay for donning those power shoes.

"By the end of the day," Rosa added, "my feet are throbbing and sometimes bleeding and swollen."

Then she took off her shoe to show a nickel-size festering wound on her left heel from wearing the pumps.

Berry, meanwhile, says she wears mostly flip flops and Crocs. Her only injury? "An occasional blister," she said.

Although podiatrists are now warning about the dangers of flip flops, damage to the feet from the use of high heels is much more widespread, they say.

"Great for business," Davis podiatrist Tracy Basso says. "I can tell patients all day long, Don't wear heels.' They'd just laugh at me. There are some very unsupportive narrow, stylish heels, with thin straps. They aren't holding the foot at all. "It's a beauty thing. Is that good for the foot? No."

Among the conditions prolonged use of high heels can cause:

n Bunions

n Hammer toes

n Neuroma (an inflammation of the nerve between the metatarsal heads in the balls of the feet)

n Achilles tendinitis

n Plantar fasciitis.

"Neuroma is a big concern," Basso said. "The toes are being dorsi-flexed and the heels are up, so the nerve is really stretched. The tighter toe box is squeezing the forefoot."

The obvious way to manage the pain is to not wear heels, said Tracey Vlahovic, associate professor of podiatric medicine and orthopedics at Temple University. Short of that, she recommends stretching the Achilles tendon after prolonged use.

Vlahovic, for one, can't understand why women put themselves through the torture of high heels.

"I was in New York City the other day and was literally walking behind this woman in 4-inch heels," Vlahovic said. "I don't know how she did it. I'd fall right on my face."

— Distributed by Scripps Howard News Service.