Nonsurgical Treatment
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, nonsurgical approaches can be used to stabilize the joint, reduce the symptoms and address the underlying cause of the condition. The foot and ankle surgeon 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 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 - 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 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. The foot and ankle surgeon will select the procedure or combination of procedures best suited to the individual patient.