Normal toe bones have bumpy enlargements on their ends called condyles. Think of how a chicken leg bone looks. The bump you feel on the toe is not a bone spur but a condyle that is prominent.
Sometimes these condyles directly oppose each other in neighboring toes. When toes press together these prominences rub and press on the overlying skin and cause thickening and pain.
1. Trimming Padding: Pressure between toes must be relieved. Gentle trimming of dead skin between toes can be performed in our office. It does not hurt and there is no bleeding. Padding between the toes but not directly on the skin lesions protects the skin over the bone prominences in a conservative way that does not hurt you.
2. Surgery: Surgical resection of bone prominence eliminates pressure and allows damaged skin to heal. Following removal of bone from the toes the patient must wear surgical shoe for first two weeks. During this time ambulation is permitted but must be restricted to necessary tasks. Healing of skin occurs in two weeks but swelling of involved digits may last up to 6 months. Appropriate shoe gear must be worn to accommodate swelling. Removal of bone frequently solves the problem but there is a risk the lesion may reoccur or in the 5th toe a floppy toe may result. Surgical complications include scar, pain, and toe misalignment. Any post operative complication or misalignment would require additional surgery for correction.
3. The decision on what type of treatment to have is dependent on many factors, but I usually padding and trimming of skin lesions with larger better fitting shoes as your first choice.