Bones have a particular alignment that allows them to work effectively. When they are not in the correct position, or they aren’t quite the right size to stay aligned, they can cause slight lumps or bumps that lead to bigger problems, like heel calluses.


A Pressure Sore

Heel Callus: Bones Under Pressure

heel callus, also known as a plantar callus, is the painful build-up of skin underneath one of your metatarsal heads. It develops when one metatarsal is slightly longer or sitting lower than the others. This causes the bony head to protrude slightly and absorb more pressure than the others around it. Over time, the friction there can cause the skin to thicken.

Although your body creates this thick spot to protect you from the pressure, the extra layer there can backfire and increase the strain on the bone, especially when you stand or walk around. This makes spending time on your feet painful.

Typically the lesion is visible, but doesn’t tend to have distinct borders. The built-up skin appears brown or grey, though it can be red as well. Sometimes it feels like you’re walking on a stone. Since the underlying issue that causes the problem is a bony one, the condition will only get worse the longer it goes untreated.


Eliminating the Friction

To effectively manage this issue, you’ll need to have the underlying cause diagnosed and treated as well. Otherwise, the constant pressure will simply encourage the spot to return. Dr. Darren Silvester and our highly-trained staff will examine your lower limbs to diagnose your condition. From there we can evaluate your options to relieve the strain on your metatarsals and eliminate the heel callus.

Conservative therapy revolves around using extra cushioning to help absorb impacts and minimize strain on the bones. Inserts that provide an extra layer in between the ball of your foot and the ground may help. You may need custom orthotics to realign your foot if another condition is contributing to the problem. These can also help protect your metatarsals from pressure. In addition, you may need to use topical medications to help dissolve the built-up layers of the plantar callus.

If noninvasive methods are not effective for relieving your discomfort, you may need surgery to address the issue with your bones directly. Procedures can help realign your metatarsal heads, or even shave off any extra protruding bone from the ends. The built-up skin may be excised at the same time as well. The surgery does come with some risks, so it should be reserved for cases where conservative measures have failed.

Plantar calluses are painful and can make it difficult to wear shoes or spend much time on your lower limbs. You need to relieve the pressure on your feet to reduce the discomfort. If you’re struggling with tough, recurring callus build-up underneath your metatarsals, contact Dr. Darren Silvester at Next Step Foot and Ankle in Pleasanton, TX. You can reach us for an appointment or for more information by calling (210) 375-3318 or using our online request form.