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I do wear heels and as for whether or not I feel the strain, it depends. It's more about the support otherwise and just how much walking I would do in them. If I were to walk around downtown all day in 6 inch heels, my feet would be killing me....but I regularly wear boots with 3 inch heels and don't feel any strain because they have nice support and my ankles get support from them being  boots instead of strappy heels. I never feel it in my back, though, and it actually makes my calf muscles quite defined because they get a workout from it. I don't have any pain from that, though.