Patients read and come up with varied things that are wrong with them. However, it is important to have a professional check-up, than just playing the guessing game.

What Is Capsulitis of the Second Toe?

 Ligaments surrounding the joint at the base of the second toe form a capsule, which helps the joint to function properly. Capsulitis is a condition in which these ligaments have become inflamed. Although it 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 pre-dislocation syndrome, is a common condition that can occur at any age.

Causes

 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 weightbearing pressure.

Certain conditions or characteristics can make a person prone to experiencing excessive pressure on the ball of the foot. These generally include a severe bunion deformity, a second toe longer than the big toe, an arch that is structurally unstable, and a tight calf muscle.

Symptoms

Because capsulitis of the second toe is a progressive disorder, that usually worsens if left untreated, early recognition and treatment are important. In the earlier stages is the best time to seek 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.
• difficulty wearing shoes.
• pain when walking barefoot.

In more advanced stages, the supportive ligaments weaken, leading to failure of the joint to stabilise the toe. The unstable toe drifts toward the big toe, eventually crosses over and lies on top of the big toe; the result – a crossover toe, the end stage of capsulitis. The symptoms of crossover toe are the same as those experienced during the earlier stages. Although the crossing over of the toe usually occurs over a period of time, it can appear more quickly if caused by injury or overuse.

Diagnosis

 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. In arriving at a diagnosis, the practitioner will examine the foot, press on it, and manoeuvre it to reproduce the symptoms. The practitioner 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.

Non-surgical Treatment

 The best time to treat this condition 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 stabilise the joint, reduce the symptoms, and address the underlying cause of the condition.

The practitioner may select one or more of the following options for early treatment:

• Rest and ice – Staying off the foot and applying ice packs help 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 – Non-steroidal 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 exercises 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.

When Is Surgery Needed?

 Once the second toe starts moving toward the big toe, it will never go back to its normal position unless surgery is performed. An orthopaedic surgeon will select the procedure or combination of procedures, best suited to the individual patient.

Your feet mirror your general health . . . cherish them!