Capsulitis of the Toe

What is Capsulitis ?

Ligaments surrounds the joints  at the base of the toes and form a capsule,  this in turn helps the joint to function properly. Capsulitis is a condition in which these ligaments have become inflamed, it commonly affects the second toe although it can also occur in the joints of the third or fourth toes.

Inflammation causes considerable discomfort and, if left untreated, can eventually lead to a weakening of surrounding ligaments which in may in time lead to dislocation.  Capsulitis or predislocation syndrome is a common condition which can occur at any age.


Often capsulitis of the second toe is a result of abnormal foot mechanics, where the ball or front of the foot under the toe joint takes an excessive amount of weight-bearing pressure, there  are many factors and characteristics that may lead to excessive pressure on the foot, the most common ones include a severe bunion deformity, second toe longer than the big toe, unstable arch , the trauma due poor foot mechanics or something as simple as tight calf muscle.


As this is often a progressive disorder and usually worsens if left untreated, early recognition and treatment are important.

Symptoms may include:

  • Pain mainly the ball of the foot giving the sensation of a small stone in the shoe
  • Swelling in the area of pain, including the base of the toe
  • Difficulty wearing shoes
  • Pain when walking barefoot



    An accurate diagnosis is essential because the symptoms of capsulitis can be similar to those of a condition called Morton's neuroma, which is treated differently from capsulitis.



    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, non-surgical approaches can be used to stabilise the joint, reduce the symptoms, and address the underlying cause of the condition.

    Early treatment of capsulitis:

  • Custom orthotic ,insoles or arch supports devices are found to be beneficial. These may be in the form of arch supports to distribute the weight away from the joint.

  • Metatarsal pad, aids in distribution away from the joint.
  • Taping ,  This helps relieve the pain and prevent further drifting of the toe and help the toe to stay in the correct position
  • Stretching. Stretching exercises may be prescribed for patients who have tight calf muscles.
  • Shoe modifications. Supportive shoes which aids control and motion to lessen the amount of pressure on the ball of the foot.

    If the unstable toe (for example: the second toe) drifts toward the big toe it will eventually cross over onto the top of the big toe resulting in "crossover toe". The symptoms of crossover toe are the same as those experienced during the earlier stages and occurs over a period of time, however, trauma caused by injury or overuse can speed the condition up.

    How we can Help

    We have found here at First Step Clinic, that many people manage at this stage with our handmade bespoke insoles and  simple padding  placed under the foot,  if you are one of the many who suffer with this why not call us where we will be more than happy to help.

    However, in severe chronic presentations, padding and insoles can still be an effective form of treatment but, on occasion's intervention of surgery is needed.