Capsulitis is inflammation of the capsular ligaments which surround a joint. Capsulitis can occur at any joint in the human body, but in the foot it is most often seen at the base of the second toe. This is a common condition which can occur at any age. Early symptoms of capsulitis can include:
- Pain in the ball of the foot
- Swelling in the area of pain
- Difficulty wearing shoes
- Pain when walking in bare feet
If capsulitis of the second toe has been left untreated for some time, there can also be weakening of the surrounding ligaments of the toe. This can cause the second toe to drift toward the big toe, and in some cases may cause dislocation of the toe.
What causes capsulitis?
It is generally thought that capsulitis of the second toe is caused by excess pressure on the ball of the foot beneath the toe joint. This can be due to biomechanical factors such as:
- Severe bunion deformity
- Second toe longer than the big toe
- Unstable arch
- Tight calf muscle
- Rigid hammertoes
In addition, activities that involve constant excessive bending of the toes can contribute to the ligaments becoming overstretched and inflamed. Climbing ladders, squatting to perform work low to the ground, and wearing high heel shoes are examples of activities that can involve excess bending of the toes.
How is capsulitis treated?
Conservative treatment of capsulitis focuses on reducing symptoms, stabilising the joint and addressing the underlying cause of the condition. Treatment options that may be recommended include:
- Ice and avoidance of activities that aggravate symptoms
- Anti-inflammatory medication
- Taping/ splinting to keep the toe in the correct position
- Stretching exercises
- Footwear advice to provide adequate support to the foot
- Custom orthotics to distribute weight away from the affected joint