Conditions & Treatments

Capsulitis of the Second Toe

What Is Capsulitis of the Second Toe

Capsulitis of the second toe occurs in the ligaments surrounding the joint at the base of the second toe. These ligaments form a capsule, which helps the joint to function properly.?Capsulitis is a condition in which these ligaments have become inflamed. 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.?

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 most commonly include a severe bunion deformity, a second toe longer than the big toe, an arch that is structurally unstable and a tight calf muscle.

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 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 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.

Symptoms

Symptoms of Capsulitis of the Second Toe 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 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 stabilize the toe. The unstable toe drifts toward the big toe and eventually crosses over and lies on top of the big toe—resulting in 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.

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