Capsulitis of the Second Toe
- Each foot has 26 bones
- There are more than 100 ligaments in each foot
- Diabetes is the #1 cause for lower extremety amputation
- A toenail takes 4-9 months to completely grow out
- Pain in the feet is NOT normal
Surgery: YES OR NO????
- Deciding whether or not to have surgery is a big decision.
- Our foot and ankle surgeons are skilled in both surgical and conservative options.
- We will present the options most suitable for you and help you with your decision.
How much pain should I be in before I make an appointment?
- Foot pain is not normal.
- Foot pain is a signal that something is not right.
- Any degree of foot pain warrants an evaluation to determine the source of the pain and possible treatment options.
- Most foot pain left untreated will get worse and become more difficult to cure.
- If you have foot or ankle pain, make an appointment, do not wait.
Will soaking cure my ingrown toenail?
- Soaking an ingrown toenail will often make it feel better, but it will not cure it.
- The symptoms of an ingrown toenail include pain, redness, and swelling.
- An ingrown toenail is easily cured with a simple in office surgical procedure.
- The toe is anesthetized so that pain is not felt during the procedure.
- The ingrown nail, or portion of the nail, is removed.
- Most people feel no pain afterwards and return to normal activities the next day.
What are orthotics?
- Custom made foot arch supports designed to hold the foot in its optimum position
- Can alleviate the discomfort caused by a number of foot conditions such as heel pain, bunions, and flat feet.
Happy Feet...Happy Bride
Comfortable footwear can help make the perfect day even better. Many times foot or ankle discomfort can be alleviated with appropriate shoes. It is not unusual for people to buy shoes that are too small for their feet. If your foot problem has an easy solution, our podiatrists will gladly provide you with that information. Sometimes the right shoe is not enough and custom-made orthotics is necessary to help the feet maintain the best position. Our podiatrists can utilize a three dimensional digital scan to have custom made inserts (orthotics) fabricated for your shoes, made from the scan of your feet to correct your specific foot abnormality and fit your feet only. If your foot or ankle problem can be resolved with conservative treatment, our podiatrists will advise you of the best treatment for you. There are times when the best solution for a foot or ankle problem is surgery. If you require foot or ankle surgery, our podiatrists can provide you with the latest state of the art surgical techniques. They will take the time to explain to you what to expect before, during and after surgery and will try to answer all your questions. Whatever your foot or ankle problem may be, our podiatrists will explain the various treatment options available to you. Everyone is happier when their feet are happy!
Thoughts on Celebrating 30+ Years
Some thoughts from Dr. Jacoby:
On April 30, 1984 I took over this podiatry practice. Elgin became my professional home as well as my personal home. I am forever grateful to Dr. Roger Hess who started this practice 50 years prior. Dr. Hess was a gentleman whom I admired and emulated both professionally and personally. I am forever honored to continue caring for the patients who initially trusted Dr. Hess.
My first office was at 860 Summit on the East Side of Elgin. I remember painting the office myself. I moved twice into larger space at 860 Summit. Eventually we outgrew the space there and moved to larger space at the Sherman Hospital Medical Building and then finally here to 750 Fletcher. I am grateful to the multitude of patients we have had the privilege of treating and that have kept us growing. I am also grateful to the multitude of other physicians in the area whom I am so privileged to work with.
Not only has this practice grown in physical space, but we have grown technologically as we offer many state of the art alternatives. My staff has been and continues to be essential. To all my staff, both past and present, I say a most sincere Thank You.
I look back on the years with much pride and sentimentality. I look forward to the future with the same enthusiasm and joy I felt on April 30, 1984. I love what I do and every day I realize how blessed I am to be in this wonderful profession!
What is Capsulitis of the Second Toe?
Ligaments surrounding the joint at the base of the second toe form a “capsule,” which helps the joint to function properly. Capsulitis is a condition in which these ligaments have become inflamed.
Although capsulitis can also occur in the joints of the third or fourth toes, it most commonly affects the second toe. This inflammation causes considerable discomfort and, if left untreated, can eventually lead to a weakening of surrounding ligaments that can cause dislocation of the toe. Capsulitis—also referred to as predislocation syndrome—is a common condition that can occur at any age.
It is generally believed that capsulitis of the second toe is a result of abnormal foot mechanics, where the ball of the foot beneath the toe joint takes an excessive amount of weight-bearing pressure.
Certain conditions or characteristics can make a person prone to experiencing excessive pressure on the ball of the foot. These most commonly include a severe bunion deformity, a second toe longer than the big toe, an arch that is structurally unstable, and a tight calf muscle.
Because capsulitis of the second toe is a progressive disorder and usually worsens if left untreated, early recognition and treatment are important. In the earlier stages—the best time to seek treatment—the symptoms may include:
- Pain, particularly on the ball of the foot. It can feel like there’s a marble in the shoe or a sock is bunched up
- Swelling in the area of pain, including the base of the toe
- Difficulty wearing shoes
- Pain when walking barefoot
In more advanced stages, the supportive ligaments weaken leading to failure of the joint to stabilize the toe. The unstable toe drifts toward the big toe and eventually crosses over and lies on top of the big toe—resulting in “crossover toe,” the end stage of capsulitis. The symptoms of crossover toe are the same as those experienced during the earlier stages. Although the crossing over of the toe usually occurs over a period of time, it can appear more quickly if caused by injury or overuse.
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.
In arriving at a diagnosis, the foot and ankle surgeon will examine the foot, press on it, and maneuver it to reproduce the symptoms. The surgeon will also look for potential causes and test the stability of the joint. X-rays are usually ordered, and other imaging studies are sometimes needed.
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 stabilize the joint, reduce the symptoms, and address the underlying cause of the condition.
The foot and ankle surgeon may select one or more of the following options for early treatment of capsulitis:
- Rest and ice. Staying off the foot and applying ice packs help reduce the swelling and pain. Apply an ice pack, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help relieve the pain and inflammation.
- Taping/splinting. It may be necessary to tape the toe so that it will stay in the correct position. This helps relieve the pain and prevent further drifting of the toe.
- Stretching. Stretching exercises may be prescribed for patients who have tight calf muscles.
- Shoe modifications. Supportive shoes with stiff soles are recommended because they control the motion and lessen the amount of pressure on the ball of the foot.
- Orthotic devices. Custom shoe inserts are often very beneficial. These include arch supports or a metatarsal pad that distributes the weight away from the joint.
When is Surgery Needed?
Once the second toe starts moving toward the big toe, it will never go back to its normal position unless surgery is performed. The foot and ankle surgeon will select the procedure or combination of procedures best suited to the individual patient.