A new study has revealed gradual "stretching out" over time of a tendon near the ankle bone from wearing high heels and standing or walking for long periods may cause flat feet.
Scientists claim that high heels are the reason women are more likely to develop the agonising condition than men - and say their risk is increased further if they spend a lot of time standing up.
But before you resign yourself to a lifetime of sensible footwear, the researchers also say they are close to finding a cure.
Working with surgeons and scientists at Addenbrooke's Hospital, Cambridge and the University of Bristol, the team led by the University of East Anglia (UEA) researchers showed that the structure and composition of tendon specimens had changed and found evidence of increased activity of some proteolytic enzymes.
The scientists, from the University of East Anglia, believe that flat feet come about when tendons in the feet are weakened by proteins that occur naturally in the body.
This causes the arch of the foot to fall, which can lead to excruciating pain and difficulties walking.
And they say their discovery could lead to the development of new drugs to combat these proteins, called enzymes, and stop them weakening the tendons.
"Our study may have important therapeutic implications since the altered enzyme activity could be a target for new drug therapies in the future,' Graham Riley, the study leader, said.
"We have shown that similar changes also take place in other painful tendon conditions such as Achilles tendonitis, so this advance may ultimately result in an effective alternative to surgery for many patients," he said.
The study has been recently published in the journal Annals of the Rheumatic Diseases.