Pea-sized lump under the toe? [Ball of the Foot Pain]

Causes of a pea-sized lump under the toe:

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.

While it may seem harmless to let your tootsies roam free, doing so may 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 problems into more of the foot due more barefoot walking at home, m, ore barefoot running shoes and more use of dress shoes while at work,” said Dr. Tom Biernacki, DPM, a podiatrist at Prime Foot & Ankle Specialists. “This leads 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 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 that will only worsen over time. At first, you may notice some 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 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.

Morton’s neuroma [Pea-Sized Lump Under the Toes]:

A Morton’s neuroma is a swollen nerve in the ball of the foot. This usually occurs between the third and fourth toes. This is likely due to improper shoes and tightness to the calf and hamstring. This interspace neuroma is likely secondary due to compression and can lead to months of pain and swelling.

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

“It is often misdiagnosed as another condition known as Morton’s neuroma, but they are distinctly different,” Dr. Biernacki said. “The difference is that Morton’s occurs in the nerves, not the joints, and presents with sharp, excruciating pain in the 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.”

To diagnose capsulitis, 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. If you’re a dancer, cut back to what might contribute to the stress,” Dr. Biernacki 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.

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 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:

Remobilizing the toe with tape may be necessary to reduce pain and prevent further movement.