Toe Bone Spurs (Exostosis)
Many people complain of pain between their toes. These painful areas can exist between any toes, but is very common between the 4th and 5th (baby) toe. There is often a hard area or a "corn" between the toes. The skin may also appear flakey or discolored. These areas are most painful while wearing snug-fitting shoes. Women may experience this with high-heeled or pointed-toed shoes.
Another common location for bone spurs is the outside edge of the 5th toe, very close to the toenail. The skin and nail edge may become very tender from shoe pressure.
Home treatment for these problems is difficult. Sometimes patients will try applying over-the-counter corn removers or topical antifungal creams. The corn medications can temporarily remove some of the painful corn, but this type of treatment is usually not satisfactory, since the corn will return. The antifungal creams will be ineffective since these conditions are not generally caused by a fungus. Placing a soft pad between the toes can help, however the pad can be irritating. It tends to move around, has a sticky adhesive, and it can create increased pressure.
In order to correctly diagnose this problem, an x-ray is required. The x-ray will usually reveal that there is a small bone spur underlying painful corns on the adjacent sides of the two toes. It is the bone spurs that are the true cause of the problem - not the corns! Topical or skin treatments of any kind will not address the bone spurs.
Once the location of the bone spur is determined by x-ray, treatment takes 15 minutes. In the office, using local anesthesia, a tiny 1/4" incision is made, and the bone spur is removed with a special surgical burr. The incision is then closed with one or two sutures. A small dressing is applied to the toe(s). The patient is able to walk immediately in a wide-fitting shoe or sandal. There is minimal discomfort following the procedure.
Within a month after the procedure, without any additional treatment, the painful corn will start to disappear from the toe.