Corns: Kernels of Pain

Corns – painful little buggers!

Corns are essentially nature’s response to pressure and friction between toes, under and around feet, and inside footwear.  Even the tiniest seeded corn can produce such pain as to make walking very difficult.  Corns are grouped into four types – hard, soft or interdigital, seeded, and Lister’s.  Each presents differently, but are all bothersome and painful. 

Hard Corns

Hard corns often develop on the top of the toes, over prominent joints or on the sole of the foot over areas where the foot bones are more prominent.  Hammer or claw toes are especially vulnerable to the development of corns, as the elevated joints rub against footwear.  It is the constant friction between skin, bones and footwear (or lack thereof) that prompts the skin of the foot to protect itself by creating more, hard skin, which in turn, creates the corn.  

Soft Corns

Soft, or interdigital (between the toes) corns are also created as a result of pressure between toes.  When a bony joint of one toe presses on the soft space of the next toe, as a person walks, this creates pressure and friction in the space, and then a corn.  Cratered and painful, these corns are very common.  

 

Seeded Corns

Seeded corns can be ridiculously painful and range in size from less than 1 to several millimetres in diameter.  They are similar in shape to a gemstone diamond – a pointed bottom and round top.  The point at the bottom is what can make walking so painful – as the foot moves, the small ‘seed’ is pressured on in an elliptical movement, which creates a deeper point on the bottom.  These corns develop a surrounding callus, which again, is the body’s response to pressure on the foot. 

Lister’s

Lister’s corns are often mistakenly identified as a split or second 5th toenail.  In reality, what has happened is that the 5th

Lister’s corn

toe has rotated toward the outside.  When this happens, rather than walking on the pad of the toe, it is the outer edge of the small toenail that takes the brunt of walking pressure. The littlest toenail doesn’t like this at all, and so produces a hard corn in order to protect itself. 

 

 

The ‘to-do’ and ‘not-to-do’

Reducing the risk of developing corns in the first place is ideal.  Offloading pressure areas on the sole with orthotics, and using gel/silicone toe separators may be just enough to eliminate the development of corns.  If, however, you find yourself struggling with corns you already have, there are some things you can do to help.  First, please avoid using blades or scrubbing at the corns to remove them.  Corn pads are popular and may provide some relief, and these also contain Salicylic Acid, which may reduce the corn’s size.  However, if you have diabetes or any other condition which may impede the sensation in your feet, you may want to reconsider using these.  The risk of a burn from salicylic acid increases with the reduction in foot sensation.  Picking out corns with your fingers may help in the short term, but also increases the risk of infection and injury.  

Seeing or reaching corns can also be difficult; seeing out the help of an advanced foot care nurse or chiropodist is your best option. These professionals can easily visualize the corns, as well has care for them with specially designed and sterilized instruments.  DIY surgery is never a good idea. 

Padding and off-loading options

The term ‘off-loading’ essentially means to ‘take the load off’ – the bony areas of the foot.  Custom orthotics may be an excellent way to help reduce the development of corns on the sole.  When shopping for orthotics, be sure you feel comfortable with the provider, and that they assess your feet and gait, and listen to your needs.  Orthotics are expensive, and should never be painful to wear.  Don’t be afraid to return to your orthotist if you have concerns – they want you to be happy with your purchase, too. 

Gel/silicone toe separators

Soft, or interdigital corns may be reduced with the use of toe separators.  These soft, gel or silicone separators comfortably keep bony toes from pressing against each other.  These come in multiple sizes and can often be purchased at a pharmacy, or from your foot care provider.  Toe separators should be cleaned daily with gentle soap and water.  Be sure to dry well between your toes before inserting the separator.  

Footwear and Corns

L – wider toe box R – narrow toe box which encourages corn formation

The development of corns can also be reduced by paying attention to your footwear.  Shoes with a narrow toe-box will squish your toes and foot pads together, and promote pressure both between toes, and on the outside of the joints.  Choosing a shoe with a wider toe box – not a wider shoe necessarily – will help to reduce the production of corns and calluses, too. If you don’t know what size your feet actually are, visit a reputable shoe provider and get measured!  Never buy shoes without trying them on.  

Corns don’t have to exist!

Taking a few, simple steps to help reduce the production of corns will pay off.  Purchase shoes with a wider toe box, use gel/silicone toe separators to keep bony toes from touching each other. Regular foot care from a specialized health care professional will help keep your feet corn – and pain – free!

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