Capsulitis of the second toe is a painful condition affecting the ball of your foot or the base of your second toe. The “capsule” is the structure of ligaments and soft tissues encasing the joint. When inflamed, it leads to pain, swelling, and stiffness, making walking or standing for extended periods difficult.

If left untreated, capsulitis will gradually progress, leading to further disability. However, with the proper treatment and care, you can avoid chronic pain or the possibility of surgery.

Capsulitis of the Second Toe

What is Capsulitis of the Second Toe?

Also known as Metatarsophalangeal (MTP), synovitis refers to the inflammation of the joint capsule (the ligaments and soft tissue) surrounding the second toe. While it’s sometimes also referred to as capsulitis of the foot, it almost exclusively affects the second toe.

It occurs due to overuse, trauma, and wearing ill-fitting footwear that compresses or injures the capsule. As a result, individuals find it difficult to walk or stand. In some cases, it can also lead to hammertoe or crossover toe, where the second toe begins to move across the great toe.

What Does Capsulitis of the Second Toe Look Like?

The most common sign of capsulitis is a pain in the ball of the foot — sometimes described as a “pebble” in the shoe. That leads to confusion with Morton’s Neuroma, which also affects this region, but is caused by compressed nerves.

Common symptoms include:

  • Pain, tenderness, or a burning sensation in the ball of the foot or the base of the second toe.

  • Swelling, redness, or stiffness

  • A feeling of instability or “shifting” in the foot when walking or standing.

  • Difficulty wearing shoes or walking barefoot.

It is crucial to seek medical or podiatric treatment as early as possible to prevent crossover of the toe. Doing so will also avoid surgery — necessary to fix crossover toes’ painful and progressive prognosis.

Best Capsulitis of the Second Toe Treatment

Common noninvasive treatments generally involve removing the causes, resting the toe, and taping and splinting to relieve pressure and prevent crossover.

1. Taping and Splinting

Remove the pressure on the second toe, support the affected area, and brace the alignment to prevent the condition from worsening. This treatment can be performed at home — ask your podiatrist for instructions.

2. Rest, Ice, and Elevation

It is the gold standard of care — alongside the compression of taping and splinting, it forms the R.I.C.E acronym. Letting the foot heal should soothe much of the inflammation. Athletes, in particular, should consider taking a break or reducing the intensity of their activities to allow for the inflammation associated with second toe capsulitis to subside.

In addition, use a cold compress or ice pack for 15-20 minutes several times a day — avoid direct contact with the skin.

3. Physical Therapy

If R.I.C.E. proves insufficiently effective, seeking help from a physiotherapist can help. They’ll advise gentle exercises to stretch tight muscles and strengthen weak muscles of the foot.

Finally, you should avoid narrow shoes, like high heels, or flimsy, unsupportive shoes, like flip-flops, that aggravate the condition further.

5 Capsulitis of the Second Toe Exercises

Try these exercises at home on the advice of your podiatrist:

1. Toe curls

Sit in a chair and place a towel on the floor in front of you. Place your foot on the towel and scrunch up the towel with your toes, pulling it towards you. Repeat 10-15 times.

2. Marble pickup

Place several marbles on the floor and use your toes to pick them up, and place them in a cup. Repeat 10-15 times.

3. Resistance band exercises

Wrap a resistance band around the ball of your foot and hold onto the ends with your hands to alleviate symptoms of capsulitis of the second toe. Flex your foot against the band, then point your foot away from your body while maintaining tension on the band. Repeat  10-15 times.

4. Stretching exercises

Use a towel or resistance band to stretch the toes and the bottom of the foot. Sit on the floor with your legs outstretched in front of you, wrap the towel or band around the ball of your foot, and gently pull back towards you. Hold for 30 seconds, then release.

5. Balance exercises

Stand on one foot and hold for 30 seconds, then switch to the other foot. Repeat 10-15 times. It can help improve the strength and stability of the foot and ankle.

Capsulitis of the Second Toe

Best Shoes for Capsulitis of the Second Toe

Wearing the right shoes is crucial for managing the second toe’s pain and discomfort associated with capsulitis. Here are some features to look for when shopping for shoes:

  • Wide toe box — Look for shoes with a wide toe box to reduce pressure on the ball of the foot and the base of the second toe.

  • Low heel — Avoid wearing high heels — they can exacerbate the symptoms of second-toe capsulitis. Look for shoes with low heels or no heels at all.

  • Arch support — Shoes with good arch support reduce pressure on the ball of the foot and improve stability.

  • Cushioning — Look for shoes with ample cushioning to provide shock absorption and reduce pressure on the foot.

  • Adjustable straps — Shoes with adjustable straps provide a custom fit and reduce pressure on the affected area.

Look for shoes labeled as “comfort” or “orthopedic” to find options providing the right support and cushioning for your feet.

Final Thoughts

Capsulitis of the second toe is painful, but many remedies and treatments are available to help alleviate the symptoms.  If you experience pain or tenderness in the ball of your foot or the base of your second toe, it is crucial to seek medical attention.

Contact Foot and Ankle Centers to schedule an appointment and take the first step toward relieving your foot pain.