One of the oldest arguments in the field of psychology is nature vs. nurture. How much of our personality can be explained by our genetics, and how much is determined by the experiences we’ve had? The usual response is a healthy mix of both.
You can construct a similar argument for second toe pain from capsulitis, with a similar response. As with many foot problems that involve pain and inflammation, capsulitis often emerges from a variety of contributing factors. Some of them you may simply have the misfortune of being born with or can’t really control, while others are a consequence of choices you make (and can later change). Fundamentally the issue is too much stress or trauma on the ligaments at the base of your toes, but there are many routes to that destination.
For example, foot shape and mechanics often play a role. Although it’s by no means a necessary prerequisite, capsulitis is more likely to affect people who have a longer second toe than first toe. Additionally, some people simply have foot shapes or mechanics that place a disproportionate amount of stress at the ball of the foot—perhaps a bunion, or a tight calf that tugs on other muscles and ligaments.
There is also frequently an activity or lifestyle component. Hobbies or careers that cause you to do a lot of stooping, crouching, or flexing your toes, such as gardening, plumbing, electrical work, working on ladders, or sports that require lots of quick starts and stops can repeatedly overstretch and wear away at the ligaments supporting your metatarsal heads, leading to that characteristic pain and swelling.
Finally, are your shoes working for you or against you? If you frequently wear high heels (especially with heels more than 2” tall), it’s probably the latter. On the flipside, flats that are too flexible (like ballerina shoes) or flimsy (like flip-flops) can also cause excessive toe bending leading to capsulitis. The same goes for walking barefoot.
Whatever the cause, if you find pain and swelling at the base of your second toe, call Dr. Keith McSpadden and the staff of North Austin Foot & Ankle Institute for an evaluation. Just as there could be many causes, there are also many available treatment options—and the sooner you take action, the more likely a gentle, conservative approach will yield positive results. To schedule your appointment, give us a call at 512-593-2949.