*When my feet hurt, I hurt all over!* I hear this phrase daily from my patients. Painful feet make even the simplest of activities difficult to enjoy.
One of the more common problems affecting our feet is the development of corns and calluses. These form from the buildup of skin over areas of excessive friction or pressure and can be quite painful
They frequently occur over bony prominences, such as hammertoes, bunions, or bone spurs. A hammertoe is a contraction of the toe. A bunion is an enlargement or lump on the side of the foot, most commonly affecting the big toe joint. A bone spur can occur anywhere in the foot from pressure or from the pull of tendon attachments.
These deformities develop due to muscle-tendon imbalances that effect changes in bone position.
Whereas a corn or callus is the symptom, the actual cause is a bony prominence.
All of these problems, while rarely caused exclusively by tight, ill-fitting shoes, are commonly aggravated by them.
Conservative remedies may be helpful in relieving the discomfort of corns and calluses. Some people are successful in gently rubbing away the thickened skin with an emory board or pumice stone after bathing. Foot soaks and liniments are also commonly used. Cushions or pads without medication may relieve shoe pressure.
More radical self-help measures can do more harm than good.
The practice of "bathroom surgery," in which people trim these lesions themselves with razor blades or scissors, is inadvisable for obvious reasons. Store-bought preparations such as corn plasters, that claim to dissolve the lesion, usually contain acids and can bum away "good skin" in addition to the corn; they are particularly hazardous to anyone with poor circulation or altered foot sensation, such as diabetics.
For the person with a painful corn, a visit to a trained professional, such as a podiatrist, usually brings the greatest relief. These doctors of podiatric medicine can more safely and painlessly administer conservative therapy, such as debriding and padding the lesion and recommending more accommodative shoe gear. Injections may also be used to reduce the pain and inflammation.
These treatments are adequate for many patients, but for those with unrelenting problem corns, a more permanent correction may be preferred; namely, fixing the underlying bony deformity. While many patients fear surgery, it may be the only way to avoid the more serious consequences of an untreated corn: ulceration and infection.
The specific treatment course will depend on the severity of your problem, activity requirements, and medical status, and should be chosen only after careful consultation with your doctor.
Dr. Spector practices podiatry in Silver Spring.