There's Nothing Corny About Foot Pain

Although the World Health Organization has reported that people worldwide have become more sedentary, most of us still walk around at least a little — unless we're experiencing foot pain. Whether it's from your shoes, a bunion, or something else, pain can keep you off your feet.

One of the most common conditions is a corn, a type of hyperkeratosis (or thickening of the skin). Often caused by friction or pressure, corns form most frequently on the feet and hands. Some, but not all, are painful.

It's difficult to estimate how many people are affected by corns, in part because many heal without a doctor's visit. That said, a 2009 study estimated that 33% to 68% of older adults experience corns.

If you're one of the people affected, there are a number of easy ways to manage the condition.

Corns often result from mechanical trauma. This includes friction, as caused by ill-fitting sneakers, or an injury, such as a toenail digging into an adjacent toe. They can also be caused by trapped sweat.

The health care education company StatPearls noted a higher prevalence of corns in three populations: older adults, athletes and those with diabetes.

Corns are common in older adults in particular because of the way feet change with age. These changes create the optimal conditions for corns, according to Timothy Miller, M.D., a podiatrist and surgeon in Orlando, Florida, and spokesperson for the American Podiatric Medical Association.

"As we get older, we lose fat in the bottom of our feet," Miller says. This fat serves as a layer of protection between our skin and bones. Without it, skin and bone rub together, and in response "the skin needs to become thicker in order to protect itself."

This thickening could come in the form of a callus or a corn.

If both calluses and corns are characterized by thickened skin, how can you tell them apart? One difference is in the size of the affected area: Calluses tend to be larger. In fact, they can be so large that they cover, for example, the entire bottom of the heel. Corns, on the other hand, tend to be smaller.

Miller further differentiated them by their depth in the skin. Calluses grow out from the surface of the foot. Corns, however, "form a little volcano that points inward," he says. This inward growth is one reason that corns may be painful; pain is often an indication of a corn.

What about other foot conditions, like plantar warts or bunions?

Like corns, plantar warts tend to be small, but warts are caused by the human papillomavirus, or HPV. This means that warts are contagious. If one bump on your foot turns into two, or both you and your spouse suddenly have bumps on your feet, it's likely a wart.

Corns and warts can also have visual differences. According to the Cleveland Clinic, plantar warts tend to have black dots or pinpoints on them; corns do not.

As for bunions, you can use the location of the bump to help determine what it is. Unlike corns, calluses or warts, bunions always appear in the same place: at the base of your big toe. If the bump appears elsewhere, it isn't a bunion.

Since corns are caused by trauma to the foot, the first line of treatment is to identify what caused it (and then prevent it from happening again). According to the medical information website Medscape, many corns are caused by ill-fitting footwear.

If you're considering new shoes, Miller recommends sneakers — tie sneakers specifically, if possible. "Slip-on sneakers are inherently less supportive and provide less stability," he says, which could lead to increased or uneven friction; these, in turn, can lead to more or worsened corns.

The National Health Service in the United Kingdom advocates for a wide toe box; the tighter your toes are pushed together, the more likely they are to dig into one another. A wider toe box gives your foot more room.

If your toes are digging into each other, one treatment is moleskin. Wrap the padding around the affected toe to protect it from further damage. You can also use gauze or cotton to the same effect. Bandages work too, but they're thinner.

Although many stores sell over-the-counter corn removers, Miller doesn't recommend them because they don't treat the cause. "More often than not, there is an underlying issue," he said, such as friction, pressure or an injury. "That needs to be reduced." If it isn't, the corn will likely reoccur.

If you're struggling with sweat, be sure to air out your feet more frequently. Change your socks or shower after physical exertion, and spend time barefoot if possible.

To remove a corn, Miller recommends a foot soak. This softens the skin so that you can then file away the corn with a pumice stone. Aim for gentle pressure. The American Academy of Dermatology recommends a circular or side-to-side motion.

Most importantly, though: "You should not be bleeding," Miller says. Open wounds can increase your risk of infection.

To prevent possible complications, Miller advocates for checking your feet twice a day: once in the morning to, he says, to "get a baseline," and again at night to "notice any calluses that may be forming, or any nicks or cuts or scrapes." If you notice any wounds, apply bacitracin plus moleskin, gauze or bandages as needed. Doing this can encourage healing, and may circumvent a corn entirely.

When you're bathing, Miller suggests using waterproof bandages. A tiny nick in the skin may not seem like a big deal, but in a bath or shower, the dirt and germs from your body can end up on your feet — right in that cut. Covering an open wound can help prevent complications.

Many corns resolve on their own. If, however, yours isn't healing after a few weeks, or it heals and then reoccurs, call your doctor for personalized support. If your insurance allows it, Miller suggests going directly to a podiatrist, as your primary care provider may refer you.

If you have conditions that affect blood circulation, such as diabetes, Miller recommends checking in with a doctor ASAP.

"Calluses and corns can end up hurting the skin," he explains, which can lead to ulcers (or wounds that take a long time to heal). These can be more dangerous for people with diabetes, which means early treatment is especially beneficial — and can help you get back on your feet sooner.

Natalie Schriefer is an academic editor specializing in the health and human services. Her freelance writing has appeared in CNN, Bloomberg, WIRED and Inside Higher Ed, among others. You can read more of her work on her website: www.natalieschriefer.com. Read More