From the Research
To manage a 61-year-old female patient with pain from a fifth metatarsal callus, begin with conservative treatment including regular callus debridement and recommend cushioned footwear with a wide toe box and low heels to reduce pressure on the affected area. The most recent and highest quality study is not directly applicable to this specific question, but based on general medical knowledge and the principles of managing foot and ankle disorders 1, a thorough clinical examination and assessment of the patient's overall condition are essential. Key aspects of management include:
- Regular callus debridement using a pumice stone or callus file after soaking the foot in warm water for 10-15 minutes
- Recommending cushioned footwear with a wide toe box and low heels to reduce pressure on the affected area
- Using metatarsal pads or custom orthotic inserts to redistribute pressure away from the painful site
- Suggesting acetaminophen 500-650mg every 6 hours or ibuprofen 400-600mg every 6-8 hours as needed for pain relief, unless contraindicated by other medical conditions
- Advising the patient to apply moisturizing cream containing urea or salicylic acid daily to soften the callus If these measures fail after 4-6 weeks, consider referral to a podiatrist for professional debridement and more specialized orthotic solutions, as supported by the concept of orthopaedic podiatry triage 2. The pain occurs because calluses form as a protective response to repeated pressure or friction, with the fifth metatarsal being particularly vulnerable due to its prominent position on the outside of the foot. Addressing both the callus itself and the underlying biomechanical causes is essential for long-term relief.