When you stand on your own two feet, you get bunions. According to anthropologists, the reason bunions develop has to do with human bipedalism—the human tendency to walk upright on two feet instead of down on four like most mammals. In addition, while the tendency may have to do with how we walk, actual bunions are a hereditary condition, studies now show.

Doctors have found that one in four adults—and more than one in three seniors—have the painful bumps that form on the base of the big toe. For a long time, experts blamed high heels for the prevalence of the condition. However, researchers in Massachusetts discovered that far more than what shoes people wear, their parents’ feet can be linked to who will develop bunions and who will not.

Bunions occur when a bone in the toe called the first metatarsal moves inward, pushing the big toe into the others. The big to rotates slightly in place, causing a bunion to form. Left untreated, unfortunately, the condition will get progressively worse and the bump will get gradually bigger. If it goes on long enough, the deformity will spread and the second toe will become dislocated as the big toe slips under it.

Despite the hereditary nature of bunions, more comfortable shoes or orthopedic inserts can provide a degree of relief. Ice packs applied to the feet and over-the-counter pain relievers can help alleviate the pain, with cortisone injections to help restore and ease proper movement. In fact, if the condition is treated early enough, this may be all that’s needed—eventually, the foot returns to its usual shape, the bump disappears, and things are back to normal, as long as the feet are treated right.

However, in extreme cases where there is significant deformity due to the condition being ignored for too long, or if there is severe pain that interferes with ordinary activity, surgery may be needed. Fortunately, this doesn’t have to be a tremendous ordeal. Surgeons can realign the toes properly in a simple outpatient procedure, often with a short recovery time.

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