Better Me

Toe Pain, No Gain: Causes for Second Toe Pain

Are you working from home more these days? Chances are you’re still making yourself somewhat presentable from the waist up for your work calls, but you may be baring it all elsewhere – baring your feet that is.

While it may seem harmless to let your tootsies roam free, doing so may actually be taking a toll on your feet—namely your toes. Too much of the wrong kind of pressure and stress can cause toe pain and inflammation in the toe joints, known as capsulitis or metatarsalgia.

“We’re seeing more people these days with foot and ankle troubles, because so many are walking and jogging with gyms being shut down. Additionally, people are walking around the house barefoot, with socks or slippers and are even going shoeless while working out at home,” said Joseph Dobrusin, DPM, a podiatrist at Banner Health in Arizona. “This is leading to foot problems like plantar fasciitis and even joint pain, including capsulitis or metatarsalgia of the second toe.”

What is capsulitis?

Capsulitis is an inflammation of the structures surrounding the joints of the metatarsal, where the base of the toe meets the ball of the foot. The connective tissues form a capsule around the bone, which hold them together. While capsulitis can develop in the third and fourth toes, the most susceptible digit is the second toe (the toe closest to your big toe).

Capsulitis of the second toe

Capsulitis of the second toe is a progressive condition, which means it will only get worse over time. In the early stages, you may notice some symptoms of capsulitis such as toe pain, joint pain or swelling around the ball of your foot near the second toe. You may also notice it’s more painful to walk barefoot or to perform certain activities like crouching.

The most common causes of capsulitis of the second toe are generally caused by a combination of genetic factors and overuse. Certain medical conditions or characteristics can also make you more prone to experiencing pressure on the ball of the foot around the second toe joint. These include:

  • A second toe that’s longer than your big toe
  • A bunion or hammertoe
  • Flat feet or low arches
  • Wearing high heels or unsupportive shoes that cause excessive bending of the toes

Toe pain, no gain – get a proper diagnosis

The good news is that if you catch this problem early, there are some non-surgical, conservative treatment options that can get you back on your feet and toes pain-free. To diagnose capsulitis of the second toe, you’ll want to see an expert, such as podiatrist, who can properly evaluate your feet and your biomechanics. The reason for this is that capsulitis often resembles another condition, Morton’s neuroma, but the two require different treatment.

“It is often misdiagnosed as another condition known as Morton’s neuroma, but they are distinctly different,” Dr. Dobrusin said. “The difference is that Morton’s occurs in the nerves and not the joints and presents with sharp, excruciating pain in third and fourth toes and not the second toe. You’ll want to see someone who can distinguish between nerve and non-nerve related conditions so proper treatment can be given.”

Your doctor may apply pressure to your foot and maneuver it to reproduce symptoms. They may also order X-rays to confirm a diagnosis.

Treating capsulitis of the second toe

Early intervention and treatment are crucial to preventing further damage to your feet and joints. And one of the easiest things you can do to help treat this condition, but hardest for those who are very active, is rest.

“If you’re a hiker or runner, take a break for a bit. If you’re a dancer, cut back to what might contribute to the stress,” Dr. Dobrusin said. “It’s an inflammatory condition, which means you’ll want to give it time to calm down and heal.”

Your doctor may also recommend one or more of these other early treatment options:

  • Heat or ice pack. Your doctor may recommend one or the other or a combination of the two.
  • Oral medications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as Aleve, may help relieve pain and inflammation, but make sure to check with your primary care doctor first.
  • Shoe modifications. Throw those flip-flops and slippers in your closet and wear supportive shoes with stiff soles and proper arch support. Your doctor may recommend a metatarsal pad or orthotic insert to relieve pressure on your second toe and the ball of your foot.
  • Taping. It may be necessary to immobilize the toe with tape to reduce pain and prevent further movement.

Typically, if treated early, surgery is not necessary. However, if conservative treatment options aren’t effective and if you have a deformity such as a bunion or hammertoe, you may need surgery. Surgery may entail correcting the position of the toe, any associated deformity and/or repairing the injured joint capsule.

Schedule an appointment

Don’t let toe and foot pain get you down. Let Banner Health help you manage and treat your foot and toe concerns. To find a Banner Health specialist near you, visit

Got other feet concerns?

From flip-flops to hiking boots and blisters to funky feet, learn more about how to protect your tootsies. Get a leg up on foot health by checking out these quick reads on our Banner Health blog.

Related articles: