Capsulitis is a condition where the ligaments surrounding the joint at the base of the 2nd toe become inflamed. The ligaments that surround the joint at the 2nd toe forms a capsule that allows the joint to properly function.
Even though capsulitis can also affect the joints of the 3rd or 4th toes, it typically affects the 2nd toe. The inflammation results to evident discomfort and if left untreated, it eventually leads to weakening of the surrounding ligaments that results to dislocation of the toe. In addition, it can occur at any age.
What are the causes?
Generally, capsulitis of the second toe is due to abnormal foot mechanics where the ball of the foot under the toe joints endures excessive amount of weight-bearing pressure.
Certain conditions or factors increases the susceptibility to end up with excessive pressure on the ball of the foot such as:
- Severe bunion deformity
- Unstable arch
- Second toe is longer than the big toe
- Tight or taut calf muscle
What are the indications?
As a progressive ailment that becomes worsen if not treated, prompt identification and treatment is vital for capsulitis of the 2nd toe. During the early phases where it is ideal to seek treatment, the symptoms that might arise include:
- Pain or discomfort especially on the ball of the foot which feels as having a marble in the shoe or sock that feels bunched up
- Pain if walking barefoot
- Difficulty when wearing shoes
- Swelling in the site of pain including in the base of the toe
In the advanced phases, the supporting ligaments weaken which leads to failure of the joint to stabilize the toe. The wobbly toe wanders to the big toe and even cross over and lie over the big toe which result to a “crossover toe” which is the end phase of capsulitis.
Management of capsulitis
The ideal time to treat capsulitis of the second toe is during the initial phase before the toe drifts toward the big toe. At this point, conservative measures can be utilized to stabilize the joint, minimize the symptoms and deal with the underlying cause.
The doctor might choose one or several of the following options for early treatment of capsulitis:
- Rest and application of ice – staying off the affected foot and applying an ice pack helps reduce the pain and swelling. Apply an ice pack for 20 minutes and wait for at least 40 minutes before applying again.
- Oral medications – non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce the discomfort and avert further drift of the toe
- Taping and splinting – the toe might be taped so that it remains in the right position to alleviate the pain and prevent wandering of the toe.
- Shoe modifications – using supportive shoes with rigid soles are recommended since they control movement and lessens the pressure placed on the ball of the foot
- Stretching – a stretching regimen is prescribed for individuals with taut calf muscles.
- Orthotics – customized shoe inserts are highly beneficial such as arch supports or metatarsal padding that evenly distributes the weight away from the joint