Designers of the popular shoes are mostly men who don't get concerned with a little thing like pain.
NEW YORK (AP) -- Stiletto heels force a woman's back to arch, pushing her bosom out in the front and her rear in the back, further accentuating the feminine silhouette.
Men like it, and so do women, says fashion historian Caroline Cox.
"Men like an exaggerated female figure. Stilettos also make a woman seem quite delicate because you have to balance (in the shoes). She might need a man's hand," Cox says.
"Women like them because they have a reputation of being glamorous and sexy. Women also get height, which makes them feel powerful."
Cox wrote "Stiletto" (HarperDesignInternational), which traces the modern history of the ultra high heel. She credits 1950s' shoemakers Roger Vivier, Andrew Perugia, Salvatore Ferragamo and Charles Jourdan for rescuing women from the utilitarian wartime footwear of the previous decade.
Since then, stilettos have remained a fixture on the fashion scene, hitting heights in the '50s and '80s, and they're soaring now. Cox notes, though, that the look of the modern stiletto is evolving from a witchlike pointy toe to a rounder toe, and Prada, a favorite among the stylish set, is returning to a thicker cone-shape heel that was popular 20 years ago instead of the narrower slope familiar to fans of Jimmy Choo and Manolo Blahnik.
In the 1960s, the heel was square, while in the late '70s -- as a backlash against the wedge and the clog -- stilettos either had a punk-rock edge or they were disco sandals, Cox explains.
Shoes have the same appeal as handbags and jewelry: They always fit. "As long as you can afford them, you can wear most of them," says Cox, who lectures on cultural trends at the Vidal Sasson Advanced Academy in London.
Stiletto specs aren't set in stone. The heel needs to be high, thin and tapered with a metal pin running through it (that's the link to the stiletto dagger from which the heel gets its name), but it could be 3 inches or 4 -- or more. The shoe style can be a pump, slingback, strappy sandal or d'orsay.
Cox writes that American Vogue was calling Vivier's pointy-toe pumps "stilettos" by the summer of 1952.
Vivier, who created the kidskin heels with rubies worn by Queen Elizabeth II to her coronation, is widely considered to be the godfather of the stiletto. He worked in postwar Paris with Christian Dior, whose swirling New Look skirts called attention to the lower leg.
Fashion designers sometimes try to steer women toward something different, flats or wedges, perhaps, but the stiletto is a consumer-driver trend. No other shoe elongates the leg like a stiletto -- especially when worn with a seamed stocking, which is how women in the '50s did it, Cox says.
"Women have invested so much in them that they don't want them to go out of style," she says. (Cox admits to being one of those shoe-crazed women who occasionally spend upward of $500 for a fabulous pair.)
Her personal favorites are Christian Louboutins, which have a signature red underside. "He (Louboutin) is quite witty; he taps into the history of the stiletto and taps into the sexiness."
Cox's book features photos of two Louboutin shoes -- a black pump with white trim and a white see-through heel and a slingback that mimics mackerel skin. He creates shoes "for women trying to reach the sky," she says.
Most of the top designers of high heels are men because they don't get preoccupied with a little detail such as comfort. "When I interviewed men, they were all into the sexual side of the stiletto, and some, like (1970s' designer) Terry de Havilland, got the whole 'power' thing," Cox says.
She does note that Jimmy Choo designer Sandra Choi are as uncomfortable as the rest. "A stiletto is always going to be uncomfortable, it's an unnatural angle. ... You don't want them to be as comfortable as a slipper. Then everyone would wear them and they'd lose their cachet."