An Untreated Corn Can Cause Blisters, Arthritis, or Worse

Corns might seem like a relatively minor annoyance, but unless theyre treated properly, they
can lead to a number of serious conditionssome of which can prove fatal for patients with
ill health.
Pain. Before you experience a chronic secondary condition, you will likely have
worsening pain in the area of the corn, possibly followed by blisters or calluses.
You might also unintentionally change your posture to avoid pain in the foot that
has the corn, and this often puts stress somewhere else on the body.

Bursitis. This inflammation of a fluid-filled sac between the skin and bone
typically requires treatment with an antibiotic. In some cases, your doctor may
need to drain the fluid in the bursa and inject a steroid.
HAT IS BURSITIS

Bursitis adalah peradangan atau pembengkakan kantong cairan, yaitu organ yang
letaknya di bawah kulit atau biasanya di atas sendi, yang berfungsi sebagai bantalan
di antara tulang dan tendon. Kantung cairan ini disebut juga sebagai bursa.
Gejala utama penyakit bursitis adalah rasa sakit dan warna kulit yang memerah di
sekitar area yang mengalami peradangan. Rasa sakit ini biasanya akan makin
meningkat saat tubuh bergerak atau mengalami tekanan. Selain rasa sakit, area
yang terkena bursitis juga akan terasa kaku serta bengkak.
Semua bagian tubuh bisa terkena bursitis, namun umumnya kondisi ini terjadi di
pinggul, lutut, siku, dan bahu.

It is an inflamed bursal sac. A bursal sac is a sac filled with fluid that acts
to lubricate and reduce the friction between two surfaces in the body,
usually muscles and tendons as they glide over bony prominences,
however their purpose in not limited to just muscles and tendons. They
may also be found in various pressure points in different parts of the
body.
The body contains literally hundreds of bursal sacs but in the foot there is
just one naturally occurring (non-adventitious) bursal sac. It is located
between the Achilles tendon and the heel bone (calcaneaus), otherwise
known as an Achilles tendon bursal sac. Note the yellow circle in the
picture below. In this instance the Achilles tendon is protected from the

pressure of the heel bone pressing against it

when we walk.

WHAT CAUSES BURSITIS

In the foot we have a unique situation in that
between the shoes that we wear, and the
ground that we walk on various parts of the
foot are constantly being micro
traumatized, otherwise known as repetitive
stress, meaning that every time we take a
step we do a small amount of damage to a
particular part of the foot and eventually that
part of the foot begins to hurt.
The bodys response to this micro-trauma is to create a bursal sac to
initially protect, by cushioning, the area but if micro-traumatized enough
the bursal sac itself becomes inflamed and we have a bursitis.

BURSITIS IN THE FOOT

In the two pictures below, the red circles represent the most common, but
not only, sites for inflamed bursal sacs.

BURSITIS SECONDARY TO HAMMERTOES- the top of the toes are so

close to the irritating shoes that the constant rubbing of the toe
on the shoe may form a bursal sac, (a corn may also occur). The
top of the toe will typically be very tender, mildly swollen and red.

Pressing on the swollen area will cause a fair amount of pain. If

barefoot, the toe will generally not hurt, but even socks or
stockings can cause pain. If the toe is rubbed too much by the
shoe, the bursal sac can burst on its own and may become
infected.
BURSITIS ADJACENT TO A BUNION OR TAILOR'S BUNION-In fact
the true definition of a bunion is the enlargement of the metatarsal bone,
deviation of the big toe towards the second toe, and the formation of a
bursitis. Again, this is nothing more than too much pressure and friction
occurring on the bony prominences of the foot.

BURSAL SAC ON THE BACK OF THE HEEL- between the Achilles tendon
and back of the heel bone, that may become inflamed. As previously
mentioned, this is the only naturally occurring bursal sac in the foot.
SUPERFICIAL BURSAL SAC ON THE BACK OF THE HEEL-many times
there will develop a superficial area of mild redness, swelling and
tenderness just off center to the back of the heel. This is referred to as
a pump bump. Due to the enlargement of the calcaneus (heel bone)
on its posterior aspect and the constant pressure of a shoe, usually a
womens dress shoe, the body will form a bursal sac that eventually
becomes inflamed.
Patients will relate that the site hurts while in shoes but most times will
feel better without shoes or be improved with very conservative shoes,
but any outside pressure on the spot will cause pain, such as the heel
hitting the mattress if you sleep on your back.
BALL OF FOOT-a bursal sac may form on the bottom of forefoot simply
from excessive pressure of walking or running. These are usually not
visible because they are below the level of fat on the ball of the foot.
When dealing with pain on the ball of the foot under the metatarsal
heads, an inflamed bursal sac has to be a consideration along
with capsulitis, neuroma , metatarsalgia , and sesamoiditis . Generally,
when a patient complains of burning on the ball of the foot, neuroma and
bursal sac are the first two things I explore.
BOTTOM OF THE HEEL-Unlike the bursitis we have already discussed
these are usually not visible because they are deep to the fat layer on the
bottom of the foot.

When diagnosing heel pain many times I include heel bursitis as one of
the causes of heel pain. In the symptomatic heel if the patient complains
that the more they walk, the more the heel hurts, then I have to consider
a bursal sac in the heel as part of the problem. Over the years I have
actually removed an inflamed bursal sacs from the heel during heel spur
surgery.
TREATMENT OF BURSITIS
CONSERVATIVE CARE
MODIFY YOUR SHOE SELECTION-If the bursitis pain is occurring on
the toes, bunion or back of the heel area the smart money would be on
eliminating the shoes that seem to aggravate the condition. This means
wearing a more conservative shoe that reduces pressure points on your
foot. Eliminating these shoes may not in itself clear up the problem but
you can be sure that if you continue to wear the offending shoes nothing
you or your doctor do will permanently fix the problem. A recurring
theme that I use throughout this site that if you put an abnormally
shaped foot in a dressy shoe it is literally the same as trying to put a
square peg in a round hole; it will not fit.
ORAL ANTI-INFLAMMATORY MEDICATION- OK, so you threw away
those dressy shoes and the foot still hurts, now what? Depending on the
severity of the pain, over the counter anti-inflammatory medication may
do the trick. The key here is to take the medication on an ongoing basis,
according to the directions on the package to build up therapeutic blood
levels. Assuming you can tolerate this type of medication, (see warnings
about anti-inflammatory medication under my arthritis section, along with
alternative treatments you can try). take the medication for 10-14 days.
Stop if the symptoms have not dramatically improved. Keep in mind, this
therapy should be considered a short term solution, not a long term
solution.
TOPICAL PAIN RELIEVER-Over the counter pain relievers applied
topically can be very helpful in reducing the pain. Keep in mind, this is not
a cure, but just another option to reduce the discomfort. Take a look
at BLUMJK pain reliever.
ICING-The area during this period may also help reduce the symptoms.

ORTHOPEDIC PADDING-Applying padding around the area will reduce

the pressure directly on the inflamed spot and that will help reduce the
pain.
ORTHOTICS-If the bursitis is occurring on the bottom of the foot, trying
an over the counter arch support may help in an effort to redistribute
body weight and take pressure off the painful area, as well as cushion the
affected area. If that only affords you some relief, you may have to
consider orthotics.
MEDICAL CARE
DRAINING THE BURSITIS-We, as foot specialists, have a few things we
can do to reduce the pain. If the bursal sac is very superficial we can
usually drain the sac, which will should alleviate the problem, but with the
warning that if the offending cause is not eliminated the problem may
return.
CORTISONE INJECTIONS-May be very helpful in reducing the pain of
the bursal sac. More than one injection may be necessary.
PRESCRIPTION MEDICATION-If over the counter medication does not
work, then prescription medication including oral prednisone may be
prescribed.
PHYSICAL THERAPY-Usually for the deeper type of bursitis is also
helpful.
SURGICAL INTERVENTION-Correcting a bunion or fixing a hammertoe
may be the only solution for some people to ultimately rid them of their
pain. Be sensible in your problem and try all the conservative things first,
if they do not help then surgery may make sense.

Septic arthritis. If the corn becomes infected, bacteria can spread through your
bloodstream and cause infection in one or more joints. You could experience
intense pain, redness, and swelling in the joint and have difficulty moving it. This
condition also is treated with antibiotics, and the synovial fluid in the joint is
usually drained.
Osteomyelitis. If the bacteria from an infected corn spreads, it can infect bone
tissue and nearby tendons. This type of infection often occurs in people with
diabetes and smokers, as these individuals often have poor blood circulation in

their feet. Antibiotics are usually used to kill the bacteria. In many cases, dead
bone tissue will need to be surgically removed.
Patients, particularly patients with diabetes, may have ulcerations from
chronic pressure. This can lead to infection and cellulitis.
Maceration and tinea pedis also may occur.
Because of their shape, corns intensify the pressure at the tip and
can cause deep tissue damage and ulceration