Capsulitis

Pain and swelling generally isolated to the second metatarsal joint capsule on the bottom of the ball of the foot

 

 

 

Symptoms


• Pain to the ball of the foot with weight bearing activity generally involving the second metatarsalphalangeal joint region


• Subtle swelling to the base or bottom of the second toe as compared to the asymptomatic foot


• Possible swelling on the bottom of the ball of the foot region


• Occassional sharp radiating pain secondary to irritation of the common digital nerve that extends on the bottom of the foot between the second and third metatarsal regions


• May advance to plantar plate tear on the bottom of the second metarsalphalangeal joint which can lead to instability and the development of a hammertoe deformtiy

Treatment


• Supportive shoe with adequate cushioning through the ball of the foot


• Wide toe box shoe with removable liner


Over the counter or custom orthotic with appropriate pressure relief padding to offload the painful region


Padding designed to take pressure off of the second metatarsalphalangeal joint


• Antinflammatory medications including Ibuprofen or Naproxen taken for a limited period of time at a prescription level  as recommended by your physician


• Taping of the second digit to stabilize the toe and decrease extension bending forces


• Limited use of cortisone injections into the joint with short term toe taping to decrease potential instability of the toe and development of hammertoe deformity


• Surgical correction of hammertoe deformity with plantar plate repair if confirmed plantar plate tear has been diagnosed

 

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