Posts for: July, 2010
A corn is a development of thickened dead tissue on a toe due to irritation. Corns can quite painful. It is typically due to mechanical irritation of the toe up against the shoe. The reason hammertoes are painful is either due to a corn or bursitis, which is an inflammation of the toe. Swelling sometimes occurs under the toe where the pressure is. It is important to be evaluated if you have a corn because the corn can become quite thick and can also cause an infection or ulceration (breakdown in the skin). Infections and ulcers can be dangerous with risk of bone infection and/or gangrene.
We commonly see this in diabetic patients who do not pay attention to their feet and present to the doctor's office with a swollen toe after weeks of bleeding and swelling. Most importantly we recommend being evaluated for this problem by a podiatrist. Multiple treatment options are available. Simple peeling of the corn can usually provide relief and a shoe gear change. Accommodative shoe gear is one way of conservatively treating the problem with an extra depth shoe or very wide sneaker. Many times the shoe is more the offending factor. If the toe is still swollen and painful after debridement we recommend possible cortisone injection. Lastly if conservative treatment fails we recommend a surgical procedure where we remove a small piece of bone and straighten the toe with very little post-op course.
People with high arches come into my office with a multitude of foot and ankle problems. A high arch is when the foot is shaped like a "c". This shape of the foot can cause various problems in the foot and the ankle. The mere shape of the foot causes many patients to land on- the heel and foot in an unstable manner. High arch, also called cavus foot, causes rigidity in the foot and the body's natural ability to absorb shock is hampered. Several other problems typically occur due to high arches, such a heel pain, Achilles tendinitis, painful bumps on the back of the heel called bone spurs and arch pain. The way the foot is shaped and high arched feet can be surgically corrected to change the way that it lands. The arch is typically stretched in a weird way and arch tissue gets inflamed and painful. Due to the instability bunions, or knob like structures on the side of the foot, occur and can get larger. Tendons on top of the foot and ankle typically will get strained because of the structure of the foot.
Treatment varies from patient to patient. It is important to have x-rays to see if there is what we call spurring, or bony growths (also called degenerative joint damage), that occurs due to this foot type. Caves or high arched feet can be surgically corrected, but we usually try a conservative treatment, which is usually is the treatment of choice. Typically custom orthotics, which are custom casted to your feet, will provide relief for our patients. Another device we use is an ankle foot orthotic, a bulkier device that completely encapsulates the foot and ankle. Shoe gear that is not structurally sound for a high arched foot could be quite problematic. We recommend that if you have a cavus foot type that you be evaluated by a podiatrist. Lastly, if you have a child that has this type of foot it would be best if the patient is evaluated because early detection is the key to healthier and less problematic scenarios that will occur in the foot.