Men and women who shoehorn themselves into skin-tight jeans, battle to button their trousers or knot their neckties too tightly might unknowingly suffer nerve damage, digestive disturbances and even potentially deadly blood clots.
They're victims of fashion's hidden health hazards. Even some favorite accessories, like waist-cinching belts, can compress delicate nerves in the abdomen or constrain breathing and deprive heart and brain of needed oxygen.
It's enough to make you think ancient Romans showed sartorial smarts with loose-fitting togas.
For years, we've heard orthopedic surgeons and podiatrists warn that spike-heeled pointy pumps and sky-high platform sandals and boots lead to sprained ankles, strained backs, shortened Achilles tendons, disfigured toes and arthritis. Yet those warnings fail to stop many women from taking their chances with styles that could leave them sprawled on a sidewalk.
"Who hasn't tried to squeeze into a too-small pair of shoes, or wriggle into too-tight jeans?" said Dr. Orly Avitzur, a neurologist in Tarrytown, N.Y., who started warning about too-constricting skinny jeans on her Consumer Reports blog back in 2009. "Sometimes we realize right away that our choice of wardrobe or fashion is the culprit; other times, it only dawns on us when we begin to really suffer."
When patients seek medical help for pain radiating into the thigh, or numbness, or tingling, it's unlikely they suspect that the cut of their jeans might be the problem.
But sharp-eyed physicians like Dr. Malvinder S. Parmar, medical director of Timmins & District Hospital in Ontario, Canada, might recognize the hallmarks of meralgia paresthetica, the compression of a nerve running from the pelvis into the outer thigh.
In 2003, Parmar published a description of "tingly thighs" in three "mildly obese" women who wore low-rise jeans throughout the previous few months. Their discomforts resolved after four to six weeks "avoiding hiphuggers and wearing loose-fitting dresses," according to Parmar's 2003 correspondence in the Canadian Medical Association Journal.
Fashionista and frump are both vulnerable to suffering for fashion's sake. Control-top pantyhose and compression undergarments designed to minimize tummies, flab and muffin tops "have flooded the marketplace and invaded our closets," Avitzur said. She advises anyone who develops physical ills from these undergarments to ditch them: "They are not worth the pain."
Avitzur has watched skintight Lycra and Spandex undergarments catch fire among teen athletes. A 15-year-old high school soccer player came to her last year with numbness, tingling and discomfort in her left thigh. Avitzur diagnosed a compressed nerve likely caused by Spanx.
The patient said all her teammates wore colored Spanx beneath their uniforms. Avitzur was stunned. "I didn't believe someone so young would be wearing the equivalent of our mothers' generation's girdle," Avitzur said.
Some clothing-related maladies go by mundane-sounding names that hardly hint at their potential to sicken. For example, a middle-aged or older man whose belly hangs below the waist of his pants may suffer from "tight pants syndrome," a term coined in a 1993 article by Dr. Octavio Bessa, an internist in Stamford, Conn.
Bessa described a collection of gastrointestinal symptoms including abdominal pain, heartburn and reflux a few hours after meals that he would see in 20 to 25 men every year. The common thread: All wore ill-fitting pants with waistbands several inches smaller than their bellies, Bessa reported in the Archives of Internal Medicine.
Three years later, two diagnostic imaging specialists from Wales described a "sporting variant" of tight-pants syndrome that they linked to tight Neoprene bike shorts worn to prevent muscular injury. Drs. Charles G.F. Robinson and Nigel Jowett recounted how the shorts blocked venous blood flow in the legs of a 25-year-old man after his workout on a stationary bike. The doctors determined he'd suffered deep venous thrombosis (DVT), clotting probably exacerbated by a hip fracture four years earlier.
Despite treatment with blood thinners, the patient later developed a dangerous pulmonary embolism, indicating a clot had traveled to his lungs.
Women suffer their own tight-pants agonies, too. A gynecological variation can foster yeast infections, pelvic pain, itching and irritations easily mistaken for a sexually transmitted disease. The solution? Looser, cotton clothing.
The way a woman wears her slacks might leave her prone to the breakdown of fatty tissue at the outside of the thighs, called lipoatrophia semicircularis, dermatologists say. "Persistent mechanical pressure" exerted by "strangling folds" of too-tight trousers can impair circulation and set the stage for this condition, especially in women who sit for long periods, according to a study from Chile's Universidad Andres Bello in the June 2007 Journal of Dermatology.
Wearing tight neckties and shirts with constricting collars can impede blood flow through neck veins and arteries and may affect vision. In a 2003 study of 40 men, half with glaucoma, three minutes with a tightened tie raised eye pressure among the majority of those with and without the disease. Elevated eye pressure is a key element of diagnosing and monitoring glaucoma, a leading cause of blindness.
The lead researcher, Dr. Robert Ritch, a glaucoma specialist at New York Eye and Ear Infirmary, maintained in the study in the British Journal of Ophthalmology that the transient rise in pressure readings "could affect the diagnosis and management of glaucoma." But several prominent glaucoma specialists said the study failed to establish that transient high pressure from the tightened ties could cause glaucoma.
Tight neckties also can limit neck movement and raise muscle tension in the upper back and neck, researchers at Korea's Yonsei University reported last year in "Work: A Journal of Prevention, Assessment and Rehabilitation." They tested 30 computer workers when wearing and not wearing tight neckties and concluded that "it is especially important for male workers to select and tie neckties appropriately" to prevent musculoskeletal injuries.
Although clothing-related pain and dysfunction can affect almost everyone, Avitzur said women have a tendency to overlook discomfort, for the sake of appearance. An admitted fashion health victim, Avitzur said she had worn ill-fitting boots and "too-heavy earrings that tore through one of my lobes."
She got the idea for a blog about skinny jeans while at the office of the plastic surgeon who repaired the damage from her poor earring choice.