Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Corn and Callus, Infected


Related Terms

  • Callositas
  • Callosity
  • Clavus
  • Heloma
  • Tyloma

Differential Diagnosis

Specialists

  • Dermatologist
  • Family Physician
  • Orthopedic (Orthopaedic) Surgeon

Comorbid Conditions

Factors Influencing Duration

The location of the callus or corn, extent of the infection, presence (and severity) of pain, response to treatment, and the individual's job requirements influence the length of disability.

Medical Codes

ICD-9-CM:
700 - Corns and Callosities; Callus; Clavus

Overview

Both corns (clavus or heloma) and calluses (callosity, callositas, tyloma) are areas of thickened skin resulting from repeated rubbing or pressure.

Calluses can form anywhere on the body but usually appear over bony areas such as fingers, feet, elbows, or in any place where the skin is subject to repeated rubbing or pressure. They may be oval or elongated; yellow, gray, or brown in color; and slightly elevated with a smooth surface. They are generally not painful.

Corns appear on the feet and typically result when poorly fitting shoes cause pressure and/or friction to the feet, particularly if there is an underlying joint deformity. In addition, shoes that are too small or too pointed (common in women's shoes) cause the toes to press together. This pressure can also produce corns. Corns are usually yellow or brown in color and ring-shaped. Hard corns occur most commonly over the top and side part of the fifth toe (the little or baby toe) while soft corns arise between toes, typically between the fourth and fifth toes. Unlike calluses, corns tend to be quite painful.

Source: Medical Disability Advisor



Causation and Known Risk Factors

Calluses are equally common in men and women but corns occur more frequently in women than in men.

Source: Medical Disability Advisor



Diagnosis

History: Calluses do not generally cause symptoms that prompt individuals to seek medical attention. Individuals with corns usually complain of pain that worsens with direct pressure. If infected, both corns and calluses are tender.

Physical exam: The physical exam, the most important single factor in the diagnosis of corns and calluses, reveals a thickening of the skin. Calluses are generally oval or elongated; yellow, gray, or brown in color; slightly elevated; and generally painless. Calluses can occur on any part of the body but are usually found on the fingers, elbows, feet, or other areas exposed to repeated pressure and/or friction. Corns tend to be ring-shaped and painful. Corns occur on the feet, usually on the toes.

If corns or calluses are infected, the area is tender. The surrounding skin may be red and warm to the touch. In some cases, pus is present. The individual may have a low-grade fever.

Tests: Physical examination and history are generally sufficient to make a diagnosis. Tests are not normally required. However, in some cases, weight-bearing x-rays may be helpful in determining the cause of the problem.

Source: Medical Disability Advisor



Treatment

Calluses do not normally interfere with an individual's daily life, so treatment is not required. In fact, calluses can provide a protective cushion and are best left untreated. Examples of this include calluses on the fingers of guitar players and on the hands of manual workers or athletes. However, if the callus is bothersome, it can be removed either by scraping or shaving. Similarly, the individual can soak the callus in warm water during bathing and rub it with a pumice stone to gradually remove it. Development of new calluses can be prevented through avoidance of repetitive friction or pressure. Protective padding sold at most pharmacies can be helpful. If the calluses are on the feet, properly fitting shoes may help prevent recurrence.

Corns generally require treatment because they cause pain. The most effective treatment involves the selection of proper shoes. Shoes should be flat or low-heeled and made of soft leather. The toe box should be rounded or squared in shape with adequate room for the toes, and the shoe should be wide and long enough to accommodate the foot comfortably. Shock absorbing padding may be helpful in relieving pressure on the feet. Medications are available to apply to the corn. These medications are generally effective, although the process may be slow and there is the potential for ulceration or infection. Faster results can be obtained by having a nurse or physician scrape or shave the lesion.

Analgesics or nonsteroidal anti-inflammatory drugs may be used for acute pain. Cyclooxygenase-2 (COX-2) inhibitors are a group of newer drugs that reduce pain and inflammation with fewer gastrointestinal side effects, although their association with an increased likelihood of coronary artery disease has caused some manufacturers to withdraw their medications from the marketplace. In general, in situations where COX-2 medications are felt to be necessary, use of the lowest dose for the shortest time period is recommended. In cases in which an underlying physical deformity is causing the corn, surgery to correct the deformity may be considered.

Infection is treated with antibiotics taken by mouth or applied directly to the skin. Sometimes both types of antibiotics are used.

Source: Medical Disability Advisor



Prognosis

Corns and calluses are associated with an excellent prognosis and are generally responsive to treatment.

Source: Medical Disability Advisor



Complications

Corns and calluses are generally uncomplicated. Advanced or untreated infections can lead to ulceration of the skin or infection of the blood (sepsis). Sepsis can progress to coma and death. Infection is much more common in individuals not able to care for themselves or who have poor circulation or diabetes.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

For most individuals, work restrictions or accommodations are not necessary. In some cases, individuals with corns may need to avoid prolonged standing or walking until the condition resolves. If job requirements dictate a certain type of footwear, individuals with corns may benefit from reassignment to a position in which comfortable footwear can be worn.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Does individual have a patch of thickened skin from repeated rubbing or pressure? Where is it located? Fingers, feet, or elbows?
  • Is corn or callus infected?
  • Is skin red and warm?
  • Is pus present?
  • Does individual have low-grade fever?
  • Was causative organism identified through wound culture?
  • Have other conditions, such as plantar warts, bursitis, and misalignment of the joints, been ruled out?

Regarding treatment:

  • If callus was bothersome, was it removed either by scraping or shaving?
  • Did individual soak callus in warm water and rub with pumice stone?
  • Were sources of rubbing or pressure eliminated?
  • Did individual with corn switch to comfortable flat or low-heeled shoes made of soft leather with adequate room for toes? Do shoes have sufficient padding to relieve pressure?
  • Was area kept clean?
  • Were topical or oral antibiotics administered?
  • Did symptoms persist? If so, was repeat culture done?

Regarding prognosis:

  • Does individual have conditions such as poor circulation or diabetes mellitus that may impact severity of symptoms and lengthen recovery?
  • Was infection advanced or untreated? If so, did ulceration or infection of blood (sepsis) result?

Source: Medical Disability Advisor



References

General

Scardina, R. J., and S. M. Lee. "Corns." Essentials of Physical Medicine and Rehabilitation. Ed. Walter R. Frontera. 1st ed. Philadelphia: Hanley & Belfus, Inc., 2002. 417-417.

Wexler, D., and T. A. Kile. "Bunion/Bunionette." Essentials of Physical Medicine and Rehabilitation. Ed. Walter R. Frontera. 1st ed. Philadelphia: Hanley & Belfus, Inc., 2002. 407.

Source: Medical Disability Advisor






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