Media with 16° slope is an effective solution to reduce low back pain risk caused by prolonged standing. In this study, we examine the effect of shoes on lower back pain caused by prolonged standing for 2 hours on sloping medium. However, prolonged standing has another major risk: lower extremity pain. Many studies has shown that this risk can be affected by shoes type or characteristic. Hence, lower extremity pain risk is the main concern in this research. Two types of shoes observed in this study are Safety Shoes and Slip-On Shoes, as these are the most widely used in the manufacturing industry. Using the Surface Electromyography (S-EMG) method, the difference in Medial Gastrocnemius muscle response was measured against both types of shoes. The study showed that both types of shoes have different muscle activation values and the Safety Shoes showed greater activation. This result proves that, type of shoes may affect the amount of lower extremity pain caused while standing for 2 hours on sloping medium and Safety Shoes poses a greater lower extremity risk. Both Visual Analog Scale (VAS) and Foot Pain Questionnaire methods supported the finding. While the results of VAS method found standing for 2 hours on sloping medium has a greater lower extremity pain than low back pain risk. Foot Pain Questionnaire method indicated that the activity of standing for 2 hours over sloping medium causes a high pain on thumb toe and the back of foot. Based on this study, it can be concluded that it is necessary to design a special shoes for prolonged standing occupation on a sloping medium that can reduce the lower extremity pain risk, besides low back pain risk.