I’m 22-years-old and I like wearing fashionable shoes. Most of them have pointy toes. My mother (and grandmother) have bunions. They both tell me the shoes have got to go if I don’t want to end up like them. Is this just an old wive’s tale?

That’s a good question because certainly there are many women who wear high-heeled, pointed-toed shoes without ever developing bunions. But there is some evidence that there’s a genetic component, which can predispose you to bunions. In other words, you are at risk for developing bunions just by the fact that you have a positive family history (two generations worth at least!).

Adding an environmental factor (shoe wear) to genetics increases your odds of developing bunions even more. Does it guarantee this will happen to you? No, but experts advise women like yourself to practice an ounce of prevention to avoid this unsightly and painful deformity. Research shows that once it gets started, there’s no stopping it short of surgery. And people have tried everything: toe spacers, tape, foot exercises, special shoes, and so on.

There is some evidence that a special shoe insert called an orthotic to support the arch might help prevent bunions in people at risk. But this only under investigation and hasn’t been proven yet. And although there are orthotics designed to fit inside a high-heeled shoe, there’s no evidence yet that this type of insert is enough. It may be that the foot has to be flat as well as supported by an arch support to effectively prevent bunions from developing.

The decision is yours, of course. You might try wearing supportive, flat shoes whenever you aren’t wearing fashion shoes. You can consult with an orthopedic surgeon or podiatrist to see if there are any signs of bunions developing yet. This information might help guide you in making your decision about shoe wear.