There are numerous over the counter treatments for corns and calluses. Some of these remedies have an acid in them that burn the callous off. Care should be taken when using these medications. If used incorrectly they can cause a chemical burn to the skin. Additionally these remedies are only temporary because the source of the pressure has not been alleviated. Professional treatment consists of using a special shoe insert called a functional orthotic that corrects foot function. In certain instances surgery may be recommended. Surgery is directed at correcting the alignment of the offending bone. Metatarsal surgery is discussed in another section. There are several factors that cause the foot to flatten and excessively stretching the plantar fascia. The primary factor is the structure of a joint complex below the ankle joint, called the subtalar joint. The movement of this joint complex causes the arch of the foot to flatten and to heighten. Flattening of the arch of the foot is termed pronation and heightening of the arch is called supination. If there is excessive pronation of the foot during walking and standing, the plantar fascia is strained. Over time, this will cause a weakening of the ligament where it attaches into the heel bone. The type of bunion procedure I choose depends on how severe the bunion is. It ranges from simply shaving off a bump of bone, to cutting and moving bones, removing pieces of bone, joint implants, and occasionally joint fusions. The procedure normally takes me approximately 45 minutes to one hour to do. I make an incision on the side of the foot so that the scar is not visible. Some doctors put the scar on top of the foot; however, I feel there is no need to have a visible scar. Once inside, I access the bone and remove a small piece. Rheumatoid arthritis (RA) is a systemic disease that affects about 2.1 million Americans, mostly women and has been show to attack multiple joints throughout the body. It is estimated that 1.5 million women and 600,000 men are victims of this debilitating disease. Of these affected, approximately 90% of the people with RA eventually develop foot or ankle symptoms and deformity. In fact, many of the early symptoms of RA often include foot problems. Foot problems are more common than symptoms to the hand and only second to knee problems. These symptoms can lead to serious disability. For patients suffering from more serious biomechanical disorders the custom-made (rigid) Orthotics provide a better solution. The devices are only available from a Podiatrist. Over-pronation is the most common ailment most people suffer from. Conversely, the opposite of 'pronation' is 'supination'. People suffering from this manifestation find their feet roll outwards or 'supinate' and the arch stiffens up remaining high as the foot makes contact with the ground. The deformity affects a mere 5 percent of the population and is called a Cavus or High Arch Foot. Supinators need custom-made Orthotic devices that correct the malfunction. If you ask 10 physicians about bunions, you will get 10 different answers. As we stated earlier, a bunion develops as the great toe joint becomes deviated (or out of alignment). As the big toe starts to drift towards the lesser toes, the 1 st metatarsal head becomes more prominent. This causes an uncovering (or exposing) of the cartilage at the 1 st metatarsal head. Cartilage that is not utilized begins to wear away quickly causing arthritis to develop in the great toe joint. A bunion will also cause the foot to shift the body weight from the great toe joint to the lesser toe joints.