Can High Heels Trigger Migraines?

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Sarah Palin managed to campaign as a vice presidential candidate in Naughty Monkey heels, but don’t expect presidential hopeful Michele Bachmann to do the same.

Bachmann, reports The Daily Caller website, suffers from migraine headaches, and has told staffers that wearing high heels seems to trigger the attacks. According to one of her advisors, The Daily Caller reports

“When she gets ‘em, frankly, she can’t function at all. It’s not like a little thing with a couple Advils. It’s bad,” the adviser says. “The migraines are so bad and so intense, she carries and takes all sorts of pills. Prevention pills. Pills during the migraine. Pills after the migraine, to keep them under control. She has to take these pills wherever she goes.”

Could her heels really be to blame? “I’ve been in practice almost 50 years treating headaches, and I’ve never seen high heels as a cause of them,” says Dr. Seymour Diamond, executive chairman of the National Headache Foundation and founder of the Diamond Headache Clinic in Chicago. “I think the stress of the campaign would more often be the provoker.”

Others agree,  pointing out that women tend to wear heels for important events, and Bachmann may be no different; she may happen to have been wearing heels before important speeches or appearances that caused her some anxiety or stress, thus triggering a migraine. Migraine pain, a powerful pulsing or throbbing in one part of the brain, can be debilitating for some, and prevent sufferers from functioning. Bachmann’s staff denied the aide’s claims that the Congresswoman’s migraines can ”incapacitate” her, and maintained that her episodes are under control with medication.

Intense episodes can make patients sensitive to light and sound for days.

But while there isn’t any scientific or biological evidence that wearing high heels can be an additional trigger of migraine episodes, some female sufferers do note that the strain of wearing heels may play a part in launching attacks. “Some women recommend that you avoid high heels if you suffer from migraines because the muscular tension that heels put on your back can lead to migraines,” says Dr. Jane Andersen, member of the American Podiatric Medical Association. “But there aren’t any studies proving this link.”

Wearing heels taller than two inches can throw off the body’s alignment, tilting the pelvis and the entire back forward. That puts pressure on both the back and on the balls of the feet, all of which could translate to physical strain that might lead to headaches or migraines, says Andersen. The link between migraines and many of their common triggers, such as caffeine, bright lights and certain foods, aren’t supported by rigorous scientific studies, and high heels may simply be another factor that, for some women, might spark their episodes.

Still, as Diamond notes, what ties many of the well known triggers of migraines together is something that many of us are all too familiar with—stress. And that’s something that presidential campaigns certainly provide in spades.

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny . You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.