Are you experiencing pain in the second toe on your foot? If you didn’t drop something on your foot or have it stepped on, what could be causing this pain? Below, we take a closer look at the most common reason people experience pain in their second toe that’s not caused by a direct blow, and we explain how the condition is treated.
Second Toe Pain
The most common reason people experience pain in their second toe is due to a problem known as capsulitis. Capsulitis is a condition that is categorized by inflammation in the ligaments of the second toe. These ligaments surround the toe joint at the base and form a capsule to help the joint move properly, which is where the name derives from. Capsulitis can develop in any toe of the foot, but it is most common in the second toe.
When capsulitis sets in, the inflammation can cause considerable discomfort, and if it goes untreated, it can eventually lead to weakening of the surrounding ligaments and an increased potential for toe dislocation. Because of this, capsulitis is often also referred to as “predislocation syndrome.”
Causes and Symptoms
Capsulitis is caused by abnormal foot mechanics or uneven stress distribution where the ball of the foot beneath the toe joint takes an excessive amount of the weightbearing. Some foot abnormalities that can lead to this uneven stress distribution include the onset of a bunion, having a second toe that’s longer than your great toe, an unstable foot arch and a tight calf muscle.
Symptoms of capsulitis include:
- Pain in the second toe
- Pain in the ball of the foot
- The sensation that there’s a marble in your shoe or that your sock is bunched up
- Swelling at the base of the second toe
- Difficulty wearing shoes or discomfort while wearing shoes
- Pain when walking barefoot
- A visible drifting of the second toe towards the big toe, or even a crossing over onto the big toe
Diagnosing and Treating Capsulitis
Getting an accurate diagnosis is important because the symptoms of capsulitis and Morton’s neuroma are similar, and effective treatment options for both conditions vary, so you want to ensure you’re treating the right condition. Diagnosing capsulitis involves having the doctor listen to your symptoms, conducting a physical exam and flexibility tests, and then confirming the suspicions with an X-ray. In some instances an MRI may be ordered, but an X-ray will typically suffice.
Treating capsulitis begins with some conservative care options. The earlier treatment begins, the higher the likelihood for success. Some common nonsurgical treatment options include:
Rest and Ice – Staying off the foot and icing it can help reduce pain and swelling.
Medications – Nonsteroidial anti-inflammatory drugs (NSAIDs) like ibuprofen can help to relieve localized inflammation.
Taping or Splinting – Taping or splinting the toe can help prevent it from shifting, crossing over or dislocating.
Stretching – Stretching exercises can help prevent against capsulitis caused by tight calf muscles.
Shoe Modifications – Your orthopedic surgeon can help fit your foot into a more comfortable shoe that better supports your foot or arch, which will alleviate some of the abnormal stress. You may also be prescribed an orthotic shoe insert.
Surgery is recommended for patients for whom non-surgical management is not helpful, the deformity progresses with a deviation of the second toe, and in those who request a surgical correction. The toe is highly unlikely to return to its original position nor will the joint become stable without surgery. A minimally invasive corrective procedure can be performed on an outpatient basis to treat this problem.