I've been nursing a sprained ankle for three weeks now and at the rate I'm going, it's not going to be healed completely anytime soon and it's all my fault.

I hurt my foot not through any strenuous sport but because I've been wearing killer heels.

I came home one night after a long day tottering on 4-inch stilettos. My feet were aching, which wasn't unusual. They always hurt when I wear heels the diameter of a pencil. But this time, there was also a painful bump on my outer right ankle, which is prone to getting sprains.

The swelling didn't subside the next day. But I had to work and so merrily squashed my feet into high heels again.

The pain got worse and so I reluctantly donned kitten heels (11/2 inches) for the next few days.

As soon as the swelling went down, I was back to my 4-inch heels. But when the pain returned, this time on both sides of the foot, I changed to flatter footwear. When the pain subsided, out came my high heels.

This ding-donging has been going on for three weeks and it's ridiculous, I know. Every night, I drown my ankle in Yoko Yoko muscle ache ointment and paste a Salonpas plaster over it. All because I want to - I need to - wear my heels.

The sensible thing to do is to forget about wearing heels for a long period - say a month - to allow my ankle to heal completely. Once it's good again, I can go back to my stilettos. But one month in flats?

The horror.

What is it with women and high heels? Why do some of us persist in wearing shoes that contort our feet to be almost vertical (surely not what Nature intended) and in the process crushing our toes and giving us ugly bumps?

Doctors have long warned women against wearing high heels for extended periods as they wreak havoc on the body. These are just some ways:

• High heels cause your centre of gravity to be pushed forward. To compensate, you bend your lower back. That changes the position of your spine, putting pressure on the nerves in the back. This can cause sciatica where nerves become trapped, triggering pain and numbness as far down as the feet.
• This altered posture also places excessive force on the inside of the knees and can lead to knee osteoarthritis, a painful, degenerative joint disease. A study found that knee joint pressure increases by as much as 26 per cent.
• Excessive pressure is also placed on the front of the foot. Pressure increases by 76 per cent when you wear 3-inch heels.
• You can also get joint pain in the ball of the foot.
• Calf muscles contract and adjust to the height of the heel, leading muscles to shorten, tighten and ache.
• High heels, combined with a narrow toebox, can lead to a thickening of tissue around a nerve between the third and fourth toes. Result? Pain and numbness in the toes.

Squashing your feet into tight shoes can cause ugly and painful bony growths at the side of your feet called bunions. The toes may also curl up to fit the footwear and can become permanently bent, resulting in that awful sounding condition called hammertoes.

You would think that women would be scared by all this, but no, we happily pay huge amounts of money for these instruments of torture.

It hasn't helped that heels have been getting higher in recent years. It's hard to find a 'fashionable' shoe these days that's less than 3 inches high.

I'm a victim too. My shoe cupboard is filled with heels that average 31/2 inches. I've even one that's nearly 5 - a ponyskin Pedro Garcia pair that I paid a bomb for. I feel like a stiltwalker at Chingay whenever I hoist myself onto them - not that I've ever worn them outside. They're too high. I just parade around the house in them.

What I've also discovered is that expensive shoes are as capable of hurting your feet as a cheap pair. While designer shoes are definitely better made, look smarter, smell better, come in softer leather and prettier packaging (I love those shoe bags), a brand name is no guarantee of comfort.

My ankle woes are a result of wearing Christian Louboutin. My Miu Miu heels pinch my toes horribly and my Moschino gives me blisters.

Yet women - most women anyway - love heels. An exquisite pair makes our heart beat faster. We walk into On Pedder filled with lust and desire.

The reason is simple. While high heels might hurt, they also make us taller, sexier and more confident. They lengthen our legs, lift our bottom and make our hips sway.

Actually, a man describes it best.

Last year, British writer A. A. Gill wrote a funny piece in Britain's The Sunday Times about his experience wearing a pair of red stilettos (size 44). His conclusion about high heels:

'They are... like women themselves, a contradiction. On one foot, they're symbols of authority, intimidation, emancipation and sexual domination. They give height and form and a skilful dexterity. On the other foot, they're a self-inflicted Western version of Chinese foot-binding, a painful mutilation. They hobble women, making running impossible.

'The position of the foot tilts the pelvis, accentuates the buttocks, raises the organs of sex to the height of a male groin. They make women available objects. Just as instantly as the stilettos became a fashion classic, it also became a pornographic one, dribbled over and fetishised. Like pornography, the stilettos can boast being one of the few symbols of both feminist equality and sexual exploitation.'

There's another reason women love high heels: they equate youth.

Old women don't wear heels. They've reached a stage where safety and comfort are more important than style and striking a pose. They no longer wear heels because they no longer need - or want, or will get, in any case - a second look from anyone, men or women.

A study in Britain found that the height of a woman's heels varies throughout her life. In her 20s, she favours high heels. When she starts a family, heel height drops. In her late 30s and mid-40s when her career hits its peak, heels start to inch higher. Then when she moves into her late 40s and 50s, it drops again.

The study by department store Debenhams found that on average, a woman will give up her heels by the time she's 63. She then settles for inch-high footwear.

'Deciding to put away their high heels for the last time can have the same psychological impact upon women that retiring from work has upon men,' a spokesman for Debenhams told Britain's the Daily Mail in a story in February.

'It's an all too public admission that they are getting older, and so naturally many women want to postpone this evil day for as long as possible... It's a climb down which can cause a lot of heartache.'

Which is why I'm worried that my ankle is not healing. The thought of having to give up spiky heels for the sort of shoes my mother wears - flat, padded, spacious and sensible - fills me with horror.

Perhaps going cold turkey for a month to let the ankle recover is not too steep a price to pay if I want to wear stilettos again. It's a short-term sacrifice for long-term pleasure.

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