The fifth toe corn is one of the most common problems seen by Podiatrists. In all shoes the first toe and half of the second toe occupy fifty percent of the front of the shoe. This presses the other three and one half toes into the remaining half of the shoe. Shoe pressure is also greatest upon the fifth toe. The fifth toe generally moves downward and rotates inward as we mature due to its inherent weakness. As a result, the toenail faces the side of the shoe. This is known as varus rotation.
The fifth toe has three bones forming two joints. Each of these bones is wide at the end and narrow in the middle. Just press your toes to feel the natural bumps in these bones. Your shoes put constant pressure on them. This irritation signals the toe to form a protective callus. For a period of time this will prevent further reaction from the body. The callus eventually becomes a further source of irritation to the toe and eventually a painful spot develops in its center. We now have a corn. Removal of the corn by “shaving” with a blade or knife will provide temporary relief, as will corn pads or chemicals. But since the shoes are still pressing against the bone(s), the corn and its intense pain will probably recur. This temporary treatment, known in Podiatry as palliation, is usually repeated every few months. For those chronically painful corns in patients whose medical condition does not exclude them, surgical correction is often available. Generally, treatment for this type of problem usually begins with x-rays. Examination will reveal the bony prominence(s) at the root of the problem. After the bony prominences are surgically removed, usually under local anesthesia, a special shoe is worn for two to three weeks after surgery.
Palliation can usually help keep these corns under control unless the pain becomes extreme or the corn rapidly recurs. Either way, your podiatrist has a solution to end this common painful problem.
This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle Surgeons, a professional society of 5,700 podiatric foot and ankle surgeons. Members of the College are Doctors of Podiatric Medicine who have received additional training through surgical residency programs. The mission of the College is to promote superior care of foot and ankle surgical patients through education, research and the promotion of the highest professional standards.
Copyright © 2004, American College of Foot and Ankle Surgeons, www.acfas.org