Dr. Gregory Iwaasa, podiatrist at Mid Dakota Clinic (Submitted photo)

There are comfortable shoes. There are sensible shoes. And then there are high-heeled shoes: stylish, but often neither comfortable nor sensible.

"Your shoes affect more than your feet," says Dr. Gregory Iwaasa, a podiatrist at Mid Dakota Clinic. "High heels change the position of your foot and ankle as well as the weight distribution of your body. Most high-heeled shoes have a pointed toe box that pushes the toes together and forces them into an unnatural triangular shape. The pressure on the ball of the foot increases with the height of the heel, placing even more pressure on the front of the foot as it's forced into the pointed toe box. High, narrow heels bounce and wobble as the heel makes contact with the ground, making your feet and ankles struggle for stability with every step."

The long-term effects of wearing high heels will vary depending on the height of the heel, the overall shape and fit of the shoe and how often they're worn. The width of the heel matters, too. There's a reason they're called "stilettos" (an Italian term for a thin, pointed dagger) -- those slender heels have you balancing on a pinpoint. In stilettos your weight becomes concentrated, placing even more pressure on the ball of the foot and making it more difficult to balance.

Many common foot problems can be either be caused or aggravated by high heels:

Bunions: A bunion is a bony bump that forms at the base of the toe when it's pushed against the next toe. Bunions typically form on the big toe, but they can form on the smaller toes as well.

Ingrown toenails: Pressure on the toes being forced too tightly into a narrow toe box can cause this painful condition. It usually occurs in the big toe, but smaller toes also can be affected.

Hammer toes: The toes are bent upward at the middle joint, forming a hammer-like shape. Corns and callouses can form at the top of the bent joint as it rubs against the top of the shoe.

Equinus: Think of how you normally take a step, with your heel on the ground and the top of your foot flexed back toward your leg. In equinus this flexibility is limited, usually due to tightness or shortness of the Achilles tendon at the back of the ankle. Now think about the position of your feet in high heels, with your heel forced upward toward your ankle, and it's easy to see how they can cause this condition.

Neuroma: Sometimes referred to as a "pinched nerve," a neuroma is a swelling and inflammation of nerve tissue that often occurs between the third and fourth toe, causing symptoms ranging from tingling and numbness to a painful burning sensation.

Fractures or torn ligaments: Lack of stability in the shoe causes the ankle to wobble and roll, which can lead to injuries of almost any bone or ligament in the foot or ankle.

The effects of high heels aren't limited to women. Men often suffer the same foot ailments caused by western-style boots.

So how high is too high? It depends on the person.

"Too high is whatever height makes you feel unstable," says Iwaasa. "If you feel wobbly or off balance, try heels that are both lower and wider. You should feel stable and be able to stand and walk comfortably."

Does that mean you can't wear those gorgeous strappy heels that go perfectly with your favorite little black dress?

"Most women can wear high heels occasionally," Iwaasa says. "Just don't wear them every day. Save them for special occasions, and limit the time you have them on. If you're going to a party, wear another pair of shoes in the car, change to your heels when you get there, and then change back again when you leave."

So go ahead and be stylish. Just be sensible, too.

When you're shopping for shoes, there's a lot more to consider than style and price. Some shoe-shopping tips:

1. Your feet swell a bit during the day, so shop for shoes at the end of the day.

2. Most people have one foot that's slightly larger than the other. Fit your shoes to your larger foot.

3. Don't go by the size number. As you get older, your feet get bigger as joints and ligaments relax. Sizes also vary with different manufacturers and different styles. Always go by the fit, not the number.

4. Leave your toes some wiggle room. The end of the shoe should be half an inch from your longest toe.

5. Pay attention to the fit around the heel as well as the toe. 6. Don't buy an uncomfortable pair and think they'll feel better when they get "broken in." If they don't fit properly in the store, they never will.

Karen Kallestad is a writer and social media coordinator for Odney. She works from her home office in northwestern Montana, wearing very comfortable shoes.