Capsulitis is inflammation in the ligament located at the bottom of the foot. It can be caused by trauma or abnormal structural functioning that overstretches the ligament attaching one of the toe bones to a metatarsal bone. Wearing improper footwear like high heels and performing repetitive activities that bend the toes can also cause capsulitis. Pain in the foremost part of the foot is the primary symptom of capsulitis, which is often misdiagnosed as Morton’s neuroma. Dr Gilbert Huang DPM, a foot and ankle surgeon, can help diagnose capsulitis correctly.

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 bears excess weight. A severe bunion deformity, a second toe longer than the big toe, a structurally unstable arch, and a tight calf muscle are common predisposing factors. Capsulitis of the second toe is a progressive disorder that, if left untreated, can cause toe dislocation. Early treatment of capsulitis is vital to prevent further complications.

The best time to treat capsulitis of the second toe is during the early stages before the toe starts to drift toward the bigger toe. Non-surgical approaches can be used to stabilize the joint, reduce the symptoms, and address the underlying cause of the condition. Dr Gilbert Huang DPM may choose one or more of the following options for early treatment of capsulitis:

Rest and ice: Staying off the foot and applying ice packs help reduce 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, can help relieve pain and inflammation.

Taping/splinting: It may be necessary to tape the toe to keep it in the correct position, relieve 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 motion and reduce the amount of pressure on the ball of the foot.

Orthotic devices: Custom shoe inserts, like arch supports or a metatarsal pad, that distribute weight away from the joint can be beneficial.

An accurate diagnosis is crucial because the symptoms of capsulitis can be similar to those of Morton’s neuroma, which is treated differently from capsulitis. To arrive at a diagnosis, a foot and ankle surgeon will examine the foot by pressing on it and maneuvering it to reproduce the symptoms. The surgeon 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.

If the second toe starts moving toward the big toe, it will never go back to its normal position unless surgery is performed. The foot and ankle surgeon will select the procedure or combination of procedures best-suited to the individual patient.

Capsulitis can cause considerable discomfort if left untreated, and early recognition is vital. If you experience pain in the foremost part of the foot, please consult Dr Gilbert Huang DPM for a proper diagnosis and treatment of capsulitis.