Raleigh, N.C. — Ashley Massengill, 29, wears high heels only once in a while.

A few years ago, she couldn't wear them at all.

“The way my feet were shaped, I couldn't even fit my foot in them,” Massengill said.

Even in middle school, she experienced a lot of foot pain. She inherited a predisposition for developing bunions, an often painful condition in which the big toe pushes in toward the other toes and forces the joint in the opposite direction.

“My grandmother had it, my mother has had, and my sister has bunions,” Massengill said.

Raleigh orthopedic surgeon Dr. David Boone says high heels don't cause bunions, but the height and the narrow point of the shoes can make them develop faster and lead to other complications.

“Bunion comes over and then the toe comes up like this and forms somewhat of a hammertoe,” he said, explaining the condition.

If women have bunions but no pain, they can simply try roomier shoes with lower heels.

But Massengill's problem was more severe. She had surgery at Rex Hospital.

“The bone has been cut with a circular saw,” Boone said.

Screws and pins help the realigned bones heal in a straight position.

It's four years after the surgery, and Massengill has left her rounded-toe flats at home.

“I'm wearing these today,” she said, prompting a scolding from Boone. “I can tell you I've had these for so long, they are so broken in that the toe box is actually not that tight anymore.”