Although capsulitis can also occur in the joints of the third or fourth toes, it most commonly affects the second toe. This inflammation causes considerable discomfort, and, if left untreated, can eventually lead to a weakening of surrounding ligaments that can cause dislocation of the toe. Capsulitis- also referred to as predislocation syndrome- is a common condition that can occur at any age.
It is generally believed that capsulitis of the second toe is a result of abnormal foot mechanics, where the ball of the foot beneath the toe joint takes an excessive amount of weight-bearing pressure.
Because capsulitis of the second toe is a progressive disorder and usually worsens if left untreated, early recognition and treatment are important. In the earlier stages- the best time to see treatment- the symptoms may include:
- Pain, particularly on the ball of the foot. It can feel like there's a marble in the shoe or a sock is bunched up.
- Swelling in the area of pain, including the base of the toe.
- Difficultly wearing shoes.
- Pain when walking barefoot.
An accurate diagnosis is essential because the symptoms of capsulitis can be similar to those of a condition called Morton's neuroma, which is treated differently from capsulitis.
In arriving at a diagnosis, the foot and ankle surgeon will examine the foot, press on it, and maneuver it to reproduce the symptoms. The podiatrist will also look for potential causes and test the stability of the joint. X-rays are usually ordered, and other imaging studies are sometimes needed.
The best time to treat capsulitis of the second toe is during the early stages, before the toe starts to drift toward the big toe. At that time, non-surgical approaches can be used to stabilize the joint, reduce the symptoms, and address the underlying cause of the condition.
The podiatrist may select one or more of the following options for early treatment of capsulitis:
- Rest and ice. Staying off the foot and applying ice packs helps reduce the swelling and pain. Apply an ice pack, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.
- Taping/splinting. It may be necessary to tape the toe so that it will stay in the correct position. This helps relieve the pain and prevent further drifting of the toe.
- Stretching. Stretching exercise may be prescribed for patients who have tight calf muscles.
- Shoe modifications. Supportive shoes with stiff soles are recommended because they control the motion and lessen the amount of pressure on the ball of the foot.
- Orthotic devices. Custom shoe inserts are often very beneficial. These include arch supports or a metatarsal pad that distributes the weight away from the joint.
If you believe have a foot problem and do not currently see a podiatrist, call one of our six locations to make an appointment.
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