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A capsule can hold intriguing things. Pill capsules contain drugs that can fight off infection. Time capsules hold information about a certain place at a certain point in time. In your foot, a protective capsule holds ligaments that surround the joints between your metatarsals (foot bones) and phalanges (toe bones). It holds the joint in place and helps it function smoothly. When these ligaments become inflamed, the condition that results is called capsulitis. This issue affects the joint by the second toe for the most part, but can occur in other areas as well.

Why Toe Joints Swell Up

Inflammation in this capsule in your foot is likely the result of the way it moves, which usually depends on your foot structure. Four factors can make you more prone to developing capsulitis in your second toe: the first factor is if your second toe is longer than your big toe; the second is if you have a pronounced bunion; third is if your arch is unstable; and fourth is if you have tight calf muscles.

These four factors place more pressure on the ball of your foot when you walk, which means more trauma, inflammation, and pain to the joints and the ligaments around them. It may feel like you have a stone in your shoe, or a sock bunched up under the ball of your foot. Shoes may aggravate the pain, but walking barefoot is even worse.

Is it Capsulitis—Or Something Else?

Another condition called Morton’s neuroma also causes this type of pain, so it is important to consult an expert like Dr. Andrew Irvine for a proper diagnosis. We can examine and manipulate your foot to see exactly where the problem lies and determine if stability of the joint is affected. We also use imaging tests like X-rays or MRIs to determine the extent of the damage or rule out other possible causes like fractures. If left untreated, the second toe can gradually become displaced and end up crossing over the big toe, which can make it difficult and painful to wear shoes and walk.

Treating Painful Joint Capsules


Once we have diagnosed the exact cause, we can suggest conservative treatments. Resting the joint and icing it to reduce swelling and pain are often the first steps of recovery. We may also recommend using a pain reliever until the swelling goes down. We can tape, splint, or pad the foot to keep the joint in position and relieve pressure on the painful tissue and will show you calf stretching exercises. Sometimes, a custom orthotic can be of great help in realigning proper foot structure or correcting faulty movement. Surgery will not be needed unless your second toe has crossed over your big toe because it will not move back into position on its own.

If you have pain in your forefoot, don’t let it develop to a point where surgery may be necessary. Contact Axis Foot & Ankle Clinic for an evaluation by calling (403) 477-3338. With three Calgary locations (Pacific Place Medical Clinic, Scenic Acres Medical Clinic, and Deer Valley Family Medical Clinic), help is nearby!

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