BODY WATCH : To Heel or Not To Heel : Stylish shoes take a toll on toes and backs. A doctor asks why women endure such torture.

After 1,000 years, this century saw an end to the custom of binding infant girls’ feet. So why is it that countless women engage in another form of torture--wearing high heels?

Consider the numbers:

* Because they wear high heels, women outnumber men in chronic foot disorders. According to the National Center for Health Statistics, women have twice the number of ingrown toenails, three times as many corns and calluses, and nine times more bunions.

* High heels contribute to double the number of back problems found in women than in men.

* Pointed toe boxes cause far more painful nerve tumors (neuromas) and deformed toes in women than in men.

Sadly, these problems often need lifelong care or surgery, and considering the numbers involved, the costs are staggering.

According to the American Podiatric Medical Assn., in 1991 an estimated $5.25 billion was paid to podiatrists, orthopedists and other physicians and health providers for foot care. (This did not include hospital charges in cases of surgery or the $381 million for over-the-counter foot products purchased by 47 million Americans.)

Forty years of private practice leads me to believe that a significant amount of this expense is associated with stylish shoes.

Thin soles, coupled with high heels, dramatically increase forefoot pressure, leading to another common and painfully disabling condition: irreversible loss of shock absorbing fatty tissue. Unwanted fat accumulates on our bellies and derriere but is lost over the sole--where it is critically needed for walking the average 100,000 miles over a lifetime.

Adolescents and women in their 20s and early 30s are not easily alerted to complications because high fashion shoes can be slowly deforming devices that take years before the effects appear.

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Shoe-fitting problems start early in life. A United Kingdom study of 9-year-old children found that 25% of girls--compared to 1% of boys--wore unsuitable shoes, notably a narrow toe box. The ill-fitting process continues into adulthood with 80% of women consistently wearing shoes that are too small, as reported in a study by female members of the American Orthopaedic Foot and Ankle Society.

Just as cigarettes carry a warning label, perhaps, too, should some shoes. Maybe there could be a conference of manufacturers, designers, and podiatric and orthopedic specialists to determine an acceptable range of styles and set standards. Shoes not meeting basic requirements could be labeled with a cautionary note.

More attention should also be given to the social, psychological and sexual factors embedded in the male and female psyches. Women seem compelled to be sexually appealing to men. It is regrettable that they accept a form of self-disfigurement as a consequence.

Corsets worn within the past 200 years accentuated breasts and buttocks but also put women at risk for injury because space for internal organs was severely diminished.

A definite change for the better began about 25 years ago, perhaps coincidentally, when more women started wearing pants and so-called walking or athletic shoes. Never before had women dared to challenge males in such a way.

The dramatic increase in sales of these shoes is possibly the best thing to happen to women’s feet. The U.S. Department of Commerce reports that of 1.2 billion pairs of shoes sold in 1993, one-third were in the walking-shoe category--an extraordinary 30% increase since 1970.

This healthy trend continues as shown in a recent Roper Poll, which found a drop from 40% in 1985 to 25% in 1993 of adult women who wore high heels at least twice weekly.

Time will tell whether this march toward healthier feet will continue. But be aware that no matter how appealing--or appalling--fashion shoes appear, in time they cause chronic disabling pain.

Women, it remains your battle and your choice. By taking greater responsibility, you can prevent needless misery for yourselves and future generations.