Are your jeans too tight? The health risks of skinny jeans!

According to recent headlines, wearing skinny jeans is the latest addition to the list of ‘things that are damaging our health’. Is it true that the current trend for very figure hugging legwear is causing us harm, and is that based on anecdotal evidence or does it have some credible research to support it? While you decide what pair of your favourite jeans to get into today, let’s explore the story.

What did the media say?

As you might expect, the media went pretty wild on this one. The Daily Star exclaimed, “Health alert over skinny jeans after woman hospitalised for four days”, while the Daily Mail similarly warned “Careful, girls, those skinny jeans can be a health hazard”, so clearly only women need to be worried then. The Express was even more focussed in terms of who should be concerned, leading with “Careful Kate! Doctors say skinny jeans are a SERIOUS health hazard“. Luckily the Guardian added some balance with “Russell Brand and Kate Moss take note – skinny jeans are bad for your health”, suggesting that at least one man should take heed. And how about “Your skinny jeans can land you in hospital” from health24.com, “Skinny jeans given health warning” from BBC News, “Health warning issued over skinny jeans as doctors warn wearing them can lead to nerve damage” from the Independent…I could go on, but you’ve probably got the gist by now.

While the exact telling varies slightly of course, the general details of the story are as follows (taken from the Independent’s coverage):

“…a 35-year-old woman had to be cut out of a pair after her calves swelled and ballooned in size.

The woman, who has not been named, had spent several hours squatting as she helped a family member move house in Australia. After a while, she began to have difficulty walking and lost sensation in her legs.

She fell and struggled to get up again. She was found lying on the ground hours later and was taken to Royal Adelaide Hospital where she had to be cut out of the jeans. Doctors found that her muscles and nerves were damaged.

Doctors believe the woman developed a condition called compartment syndrome; a condition caused by increased pressure within a confined body space and resulting in nerve compression.”

So far, so anecdotal. But should one’s person’s misfortune (albeit a pretty painful experience by all accounts), be the basis for health advice more generally? Interestingly, in this instance the media coverage did originate from more than a simple anecdote reported to the press. It actually came from a recently published research paper. And in fact, all the coverage listed above directs the reader to that, sometimes even with a direct link.

What did the researcher actually say?

Well firstly, and sadly as reported in the Daily Mail, “the research paper did not list the make of jeans”. The paper, published in the Journal of Neurology, Neurosurgery and Psychiatry, entitled “Fashion victim: rhabdomyolysis and bilateral peroneal and tibial neuropathies as a result of squatting in ‘skinny jeans’” and written by a team of three researcher and clinicians from the Royal Adelaide Hospital and University of Adelaide.

In the paper, which is very brief if you want to take a look, the details are pretty much as described in the media to begin with, but with further description of the tests undertaken, the treatment given, and the outcome. The patient was in hospital for four days in total. The researchers end the short description with “The present case represents a new neurological complication of wearing tight jeans”.

This paper would be an example of a single case study or case report. It’s commonly seen in medical journals where a doctor or team of doctors describe a recent experience with a patient so that others in the field might learn from it, or indeed, that it might highlight something that warrants a more detailed study in itself. That does of course mean it’s very different from a carefully controlled study where factors might be manipulated to see what effect that change has on an outcome (the design that would provide the strongest evidence for a certain factor being harmful or beneficial). Other studies where two naturally-occurring groups are compared (one group with the factor, and one without the factor) would be somewhere between those extremes of evidence.

Most reporting didn’t highlight where single case reports factor in our understanding of health risks, though of course, it was very clearly reported this was only one patient. Interestingly the Guardian followed their warning piece, with a much more helpful one “What evidence would convince me skinny jeans are bad for health?”. This is a really excellent piece of writing, illustrating what level of evidence we would need to make informed decisions, not just in the case of skinny jeans of course, but almost every health-related story we see in the media. In her piece, Suzi Gage takes you very briefly through some of the issues in interpreting what we would need to see to be convinced that wearing skinny jeans might cause compartment syndrome, for example, “Strength: This means the strength of the statistical association between skinny jeans and compartment syndrome. At the moment there are no statistics at all, so this scores a big fat zero.”

Have a read of that piece, and then consider what some of the other media outlets were focussing on, for example the Daily Mail continued, “Among the enemies of the fashion trend are the terrorist group Islamic State, which reportedly imposed 10 days in jail as a punishment for any man wearing them”. Luckily, the great team at NHS Choices pretty much sum it up with the title to their piece “A case report about skinny jeans sparks media frenzy”, though as always, their full write-up is worth a few minutes of your time.

The bottom line.

It’s important to remember that the research paper that formed the basis of all those recent headlines reported only one case, albeit that patient has clearly suffered a very painful and traumatic experience. Before we add a health warning, we would need a much better understanding of the circumstances in which skinny jeans, or other tight fitting clothing, might pose a risk. As always, that will require more than a sample of one.

In the words of Priya Dasoju, professional adviser at the Chartered Society of Physiotherapy, quoted by BBC News: “There’s no need to ditch the skinny jeans just yet, simply avoid staying in the same position for too long and keep moving throughout the day. If you do suffer any prolonged pain you should of course seek help, but no-one should be alarmed by this warning or change the cut of their jeans.”

Wai, K. et al. (2015). Fashion victim: rhabdomyolysis and bilateral peroneal and tibial neuropathies as a result of squatting in ‘skinny jeans’ . J Neurol Neurosurg Psychiatry. DOI:10.1136/jnnp-2015-310628