Ligaments have it rough. These tough, fibrous bands of tissue are responsible for keeping your bones properly lined up in position at a joint, and while they usually do their jobs well, we humans don’t always make it easy for them.
Certain activities, such as crouching or wearing high-heels, can overstretch the capsular ligaments at the base of your toes (usually your second toe) and cause it to swell, a condition known as capsulitis. The result can be aching or burning pain that radiates throughout your entire forefoot, and over time the ligaments may become so weak that they can no longer keep the toe in place, causing it to drift toward (and eventually even cross overtop) neighboring toes.
Taking a Closer Look at the Causes and Symptoms of Capsulitis
There’s some disagreement about what fundamentally causes this kind of toe pain: some think it may require a structural defect in your foot itself that shunts extra weight and pressure on the metatarsal ligaments, which aren’t designed to handle that much force. Whether that’s true or not, however, we do know certain activities or lifestyle choices can put you at much greater risk of developing capsulitis down the road. Hobbies or jobs that require a lot of stooping, crouching, or climbing ladders (think gardening, plumbing, electrical or construction work) can slowly bend ligaments past their breaking point over time. High heels are another common culprit: these shoes place all your weight at the forefoot, and over time they can wreak havoc on the ligaments in your toes.
There usually isn’t a sudden injury or history of trauma that causes capsulitis, and the pain usually isn’t sharp or sudden (although it can be). More likely, it will be a nagging, recurring ache caused by a swelling near the forefoot. You might have trouble walking when pain flares up, and you may feel as if you’re constantly stepping on a marble. Without treatment, the condition ultimately reaches its end stage: crossover toe, where the second digit drifts outward and lies overtop the first.
At-Home Strategies to Put a Cap on Capsulitis
A number of strategies (often used in combination) exist to alleviate the toe pain resulting from capsulitis. Fortunately, most patients only require non-invasive and relatively simple care. In fact, in many cases a few changes in your daily routine can bring significant relief.
If your pain can be traced to an activity such as gardening or wearing high-heeled shoes, decrease or temporarily discontinue it and give your toes a break. Instead, wear comfortable, well-fitting, low-heeled shoes with firm heels. Taking an oral anti-inflammatory as directed (provided your physician has cleared you for use) can also help you get over the initial pain hurdle.
Toppling Toe Pain
If your discomfort doesn’t go away after a few days, Dr. Harvey Danciger, DPM, is happy to help you try a few more gentle measures. Sometimes toes need buddy taping or a splint to help keep them in the right spot—this both relieves pain and also helps prevent the digit from drifting further.
Shoe inserts such as metatarsal pads or full custom orthotics provide extra padding to swollen, sensitive spots. If your discomfort is caused by a defect in the actual architecture of your feet, this approach can be particularly effective. For particularly stubborn pain, a cortisone shot usually provides the tough relief you need. Laser therapy can also help address Capsulitis pain.
Once the toe starts drifting, surgery is the only way to bring it back into place. Of course we will exhaust non-invasive options first, but if surgery is required the doctor will select an appropriate procedure based on the severity of the condition as well as your lifestyle goals.
Recurring toe pain is no fun, and it’s not normal, either. Let Dr. Harvey Danciger, DPM, help resolve your tough pain and let you get back to doing thing things you love. Call us today in Palm Desert at (760) 568-0108, or request an appointment via this website.
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