Are you suffering from pain in one or more toe joints? It could be capsulitis. Capsulitis does not have the same “name brand recognition” as other high-profile foot deformities like bunions or hammertoes. While you may not have heard of this uncomfortable condition, it’s relatively common and highly treatable when caught early. If left unchecked, can cause significant pain and deformity in the toe, ultimately leading to it “crossing over” the big toe.
Taking swift action is always the best bet if you think you might have this condition—or really any painful problem affecting your feet or toes. The good news is that, quite often, the progression of capsulitis can be halted or slowed with conservative measures. So, what is capsulitis, and how can a podiatrist help alleviate your symptoms?
What is Capsulitis?
Capsulitis affects the dense ligament structure (or capsule) around a toe joint, causing inflammation. Also known as metatarsophalangeal synovitis, capsulitis almost always affects the second toe, next to the big toe. However, it can also affect the third and even fourth toes.
People usually develop capsulitis when they frequently exert too much pressure on the ball of the foot. Other possible causes include prolonged use of ill-fitting shoes, unusual foot mechanics, or conditions such as osteoarthritis or rheumatoid arthritis. Capsulitis is commonly confused with Morton’s Neuroma, which affects the same area. However, while Morton’s Neuroma affects the nerves, capsulitis affects the ligaments. Also with capsulitis, you’ll tend to feel the discomfort directly under the base of the toe, whereas neuromas develop in the spaces between the toes.
What are the Symptoms of Capsulitis?
Capsulitis is characterized by the following symptoms:
- Swelling at the base of the second toe: This swelling can make it feel like walking on a pebble.
- Stiffness, tenderness, and sharp pain of the toe joint: Capsulitis causes pain that may affect your quality of life. You may have difficulty wearing shoes.
- Pain in the ball of your foot: You’re likely to feel pain in the ball of the foot, as well as significant swelling.
- Pain when you walk (especially barefoot): Many people with capsulitis struggle to walk without pain and may avoid walking long distances.
If capsulitis is left untreated, the second toe may move toward the big toe and even overlap. If the toe crosses over, you may experience severe pain and even joint dislocation. If you’re struggling with any of the above symptoms, it’s worth obtaining a diagnosis as soon as possible to prevent your toes from overlapping.
Tips for Caring for Capsulitis
Early treatment intervention for capsulitis will focus on two primary goals: one, reducing the severity of your symptoms, and two, slowing the rate of progression.
Podiatrists typically recommend non-invasive therapies when treating capsulitis, including:
Rest and Apply Ice to the Area
Taking a break from the vigorous activity will allow your ligaments to heal and prevent further pain. If you want to stay active, try walking or swimming instead.
Icing the area for around 20 minutes at regular intervals throughout the day will also help reduce inflammation and support the recovery process. Make sure to have at least a 40-minute break between applications, and always remember to not apply ice directly to your skin, but always wrap in a thin towel first.
Splinting and Taping
Splinting or taping the toe so it lies in the correct position will prevent further damage to the ligaments and provide effective pain relief. You won’t need a podiatrist to tape your toe, but they can show you how to do so successfully.
Taking Anti-Inflammatory Drugs
Pain relievers such as aspirin or ibuprofen can help you cope with pain while you rest. Remember to follow the label and seek advice from your doctor if necessary.
Physical Therapy
Stretching exercises can help to reduce pressure on your joint and strengthen the surrounding muscles and tendons. In the long term, this will help reduce the chances of further injury. Your physical therapy routine may even include calf stretches, as tight calf muscles can often be partially responsible for biomechanical problems that contribute to capsulitis.
Wearing Supportive Shoes with Stiff Soles
Wearing high heels or poorly structured ballet flats could aggravate capsulitis. As such, you should aim to wear shoes that will help relieve pain and support your feet.
Make sure your shoes are supportive and have plenty of cushioning for the front of your feet. You also want to make sure you’ve got plenty of “wiggle room” for the toes, including about half an inch of space between the longest toe and the front of the shoe. Finally, opt for shoes with thick, rigid soles that don’t have too much flex in the toe region.
Using Orthotic Devices
Orthotic inserts such as arch supports can help reduce pressure on the ball of your foot and support healing.
Let’s face it, sometimes simply switching to a new pair of shoes might not be enough—particularly if you have an unusual or inefficient foot structure that puts extra pressure on the ball of the foot. (This is commonly the case for people who develop capsulitis.) After evaluating your foot structure, we can help you determine whether a pair of over-the-counter inserts or custom orthotics would be of any benefit to you—and if so, which ones you should get.
Surgery in Rare and Severe Cases
Last up, the outcome that nobody truly wants—surgery. While we will do everything we can to keep you from needing a more aggressive treatment approach, sometimes surgery is the only way to permanently relieve the pain and realign your toe.
Don’t Let Capsulitis Keep You Down
If you’re tired of toe joint pain, Patel Podiatry is here to help. We’ll come up with a treatment plan that suits your health needs and lifestyle. Whether your capsulitis is still in the early stages or it’s already started to cross over the big toe, it’s never too early (or too late) to seek our help. In many cases, a little bit of care can go a long way—and the sooner you start, the better.
For more information and to book an appointment, don’t hesitate to get in touch. Call either of our two offices or complete our online contact form to request your appointment.