Stilettos, wedges, and pumps may be fashionable, but prolonged wearing of and walking in high heels can contribute to joint degeneration and knee osteoarthritis, a new study suggests.

“Obviously with research like this, you can’t say with any certainty that if you wear high heels regularly you will develop osteoarthritis. We don’t know that,” says lead researcher Danielle Barkema, an Iowa State University kinesiology master’s student.

“There are probably people [high heel wearers] who do and those who do not. However, based on this information, wearing high heels puts individuals at greater risk for developing osteoarthritis. And it seems to be that the higher the heel height, the greater the risk.”