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Advice on surgery for little toes. I have had corns on both little toes for some time now, and tried everything over the counter, also take the hard skin off around them to no avail. I have excruciating pain most of the time no mater what shoes i wear. If

3 doctors weighed in
Dr. Howard Fox
Podiatry
2 doctors agree

In brief: It

It sounds like you have hammertoes, a condition where the toes are contracted or "bent", usually in a downward position in the middle or last knuckle, and upward in the joint connecting the toe to the foot.
As a result, the top of the knuckle rubs on the shoe, and all that rubbing causes the skin to thicken (it's a protective mechanism), which is how corns are formed. Sometimes, a little sac of fluid forms called a bursa between the skin and the bone over the knuckle. It's another protective mechanism to help cushion the bone against the repetitive trauma it gets against the shoe. With enough irritation, the fluid inside this bursa can become inflamed. An inflamed bursa is called a bursitis. When this happens, the pain can get acute, and the toe can become a little swollen, warm and red as well. It's important to understand that the "corn" is not the disease, it's the symptom. The "disease" is the hammertoe. So anything you do to the corn will not be a permanent cure, only a temporary relief. The only way to "cure" the problem and stop the corn from coming back is surgery to remove a small piece of bone from the knuckle so the toe can be straightened out. The surgery takes about 10 minutes and is usually done under local anesthesia. There are 4-5 sutures and a small dressing which you'll have to keep dry for 10-14 days. During that time, you can walk, but not too much, and you'll have to wear one of those fancy post-op shoes from paris. Most patients take some sort of pain medication for the first 3-5 days. There is some pain, but it's not the spanish inquisition. After 2 weeks, the dressing comes off, the sutures are removed, and you can just wear a band aid and get into a sneaker. You should be able to get back into your stilettos in 6-8 weeks, although swelling can last up to a year. Short of surgery, there are some things you can do to help you live with your hammertoes and corns. Make sure your shoes are roomy enough for the hammertoes, and a soft leather, suede or deerskin material is less painful than a harder leather. You can also buy corn pads, which look like little donuts that you stick on your toe, with the hole placed where your corn is. Make sure the corn pads are not medicated, as the "medication" is an acid that can burn you. Since these corn pads tend to move as you walk, it's important to tape them in place with a piece of tape or even a band aid. For an episode of bursitis described above, your podiatrist can give you a little injection of an anesthetic and steroid into the toe which immediately calms the bursitis down. Also, having a podiatrist trim down the corns every so often tends to give temporary relief as well. If you do decide to have the surgery, i personally would recommend this be done in a hospital or surgery center rather than a doctor's office. The quality controls in a hospital or surgery center are much higher than in a doctor's office, and should a complication arise, however small a risk this is, you're always best off in a hospital. These days, you don't stay overnight, and you don't eat the food, so there is really no disadvantage of having this minor procedure done as an ambulatory surgery procedure. Hope this helps you make a decision. Good luck!

In brief: It

It sounds like you have hammertoes, a condition where the toes are contracted or "bent", usually in a downward position in the middle or last knuckle, and upward in the joint connecting the toe to the foot.
As a result, the top of the knuckle rubs on the shoe, and all that rubbing causes the skin to thicken (it's a protective mechanism), which is how corns are formed. Sometimes, a little sac of fluid forms called a bursa between the skin and the bone over the knuckle. It's another protective mechanism to help cushion the bone against the repetitive trauma it gets against the shoe. With enough irritation, the fluid inside this bursa can become inflamed. An inflamed bursa is called a bursitis. When this happens, the pain can get acute, and the toe can become a little swollen, warm and red as well. It's important to understand that the "corn" is not the disease, it's the symptom. The "disease" is the hammertoe. So anything you do to the corn will not be a permanent cure, only a temporary relief. The only way to "cure" the problem and stop the corn from coming back is surgery to remove a small piece of bone from the knuckle so the toe can be straightened out. The surgery takes about 10 minutes and is usually done under local anesthesia. There are 4-5 sutures and a small dressing which you'll have to keep dry for 10-14 days. During that time, you can walk, but not too much, and you'll have to wear one of those fancy post-op shoes from paris. Most patients take some sort of pain medication for the first 3-5 days. There is some pain, but it's not the spanish inquisition. After 2 weeks, the dressing comes off, the sutures are removed, and you can just wear a band aid and get into a sneaker. You should be able to get back into your stilettos in 6-8 weeks, although swelling can last up to a year. Short of surgery, there are some things you can do to help you live with your hammertoes and corns. Make sure your shoes are roomy enough for the hammertoes, and a soft leather, suede or deerskin material is less painful than a harder leather. You can also buy corn pads, which look like little donuts that you stick on your toe, with the hole placed where your corn is. Make sure the corn pads are not medicated, as the "medication" is an acid that can burn you. Since these corn pads tend to move as you walk, it's important to tape them in place with a piece of tape or even a band aid. For an episode of bursitis described above, your podiatrist can give you a little injection of an anesthetic and steroid into the toe which immediately calms the bursitis down. Also, having a podiatrist trim down the corns every so often tends to give temporary relief as well. If you do decide to have the surgery, i personally would recommend this be done in a hospital or surgery center rather than a doctor's office. The quality controls in a hospital or surgery center are much higher than in a doctor's office, and should a complication arise, however small a risk this is, you're always best off in a hospital. These days, you don't stay overnight, and you don't eat the food, so there is really no disadvantage of having this minor procedure done as an ambulatory surgery procedure. Hope this helps you make a decision. Good luck!
Dr. Howard Fox
Dr. Howard Fox
Thank

In brief: Corns

Thanks to dr fox for the treatise - how long did that take to type ? It sounds as though some form of corrective surgery is in order. See your podiatrist for help.

In brief: Corns

Thanks to dr fox for the treatise - how long did that take to type ? It sounds as though some form of corrective surgery is in order. See your podiatrist for help.
Dr. Thomas Inwood
Dr. Thomas Inwood
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