Q: I am 56, have bunions, and have painful calluses under my second toes.

A: When a person has bunions, the metatarsal bone behind the great toe does not bear its fair share of weight, which leads to a shifting of weight-bearing pressure to the second metatarsal bone. This causes calluses to build up under this bone. Orthotics (Rx shoe inserts) can be made to off-load pressure from this area, and surgery may be an option for some people, to straighten the great toe and re-establish the normal weight-bearing structure of the foot.