When it starts to warm up, clothes begin to drop off. Even our feet are more likely to see the light of day as we don sandals or flip-flops more readily or even go barefoot. And so, today’s installment will focus on the lovely part of our anatomy that is responsible in large part for getting us to where we want to go: our feet. Next month’s installment will resume discussion about our feet, but will focus on them from a dermatological and neurologic point of view.

Structurally, the foot is amazing. One foot has 26 bones that have evolved since Homo Erectus first stood up, to contribute a large part toward maintaining our balance and providing ease of movement. The stress on our feet begins around the age of 1 when as babies we learn to walk. As the feet are responsible for carrying around on a daily basis the rest of our anatomy, big and small, is it any wonder that they should be prone to injury, corns, calluses, ingrown toenails, bunions, bone spurs, arch problems, infections and complications of other body problems such as diabetes or atherosclerosis. Phew. We really don’t give our feet enough credit and attention.

This article will focus on one foot problem: bunions. The medical term for this condition is hallux valgus, which translated to simple English means “big toe turned sideways.” The bump on the side of the foot at the bottom of the big toe is actually the normal head (end) of the first of five long bones of the foot where it meets the first small bone of the big toe to create the joint that allows the toe to bend up, down, and side-to-side. A variety of reasons, over time, causes this head of the metatarsal joint to angle toward the center of the body while the toe angles toward the side of the body, sometimes to such an extent that it even overlaps the next toe. The degree to which this abnormal alignment occurs is the cause for the surrounding tissues to become inflamed, swollen and tender. All of this makes it more difficult to buy shoes and sometimes to walk properly, which then leads to other bio-mechanical problems related to the musculoskeletal system.

There are two main theories to explain the development of bunions. The first is that it is hereditary; if one of your parents had bunions you are more likely to develop them. The second theory that most people ascribe to is that poor-fitting footwear is the main cause, namely, high-heels and/or tight and narrow pointed toe-boxes in shoes. High heels force the body to walk differently putting pressure on different points of the foot. This latter theory, however, does not account for the fact that men who don’t wear the latest in fashion statement shoes can develop bunions as well as ladies.

A podiatrist is a doctor who specializes in foot care; a doctor of podiatry medicine or DPM. The word podiatry comes from the Greek pous that means foot. Interestingly, John Littlefield opened an office in New York in 1843 and was the first to call himself a podiatrist. Also, it is thought that President Abraham Lincoln may have had bunions or other foot problems because he complained of foot pains and hated to wear shoes. Unfortunately, the only curative treatment for bunions is surgical to restore the alignment of the bones. Otherwise, other treatments aim to relieve the symptoms of discomfort or pain such as wide-sized shoes, orthotics, and/or anti-inflammatory medications.

Never hesitate to check out pain in the area of the big toe joint as bunions are only one of the possible diagnoses.

• Agnes Oblas is an adult nurse practitioner with a private practice and residence in Ahwatukee Foothills. For questions, or if there is a topic you would like her to address, call (602) 405-6320 or email aoblas@newpathshealth.com. Her website is www.newpathshealth.com.

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