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Capsulitis

The Condition

Capsulitis is inflammation of the soft tissue lining surrounding a joint. The foot contains over 30 joints and each has a specific lining that can get irritated and inflamed secondary to a multitude of problems or conditions. The capsular tissue helps to maintain alignment and stability of each joint of the foot with weight bearing, ambulation and range of motion. Most people will develop pain and even swelling to the affected joint. The most common joint affected is the 2nd metatarsophalangeal joint (MTPJ).

The Treatment

After a thorough history and physical examination, your foot and ankle specialist may recommend radiographic examination. This is usually to ensure that no signs of fracture are present. Once any signs of fracture have been ruled out, your podiatrist could recommend any of the following treatments: oral anti-inflammatory medication, injection therapy with local anesthesia and steroids, padding of the shoe insert, or even custom made foot orthotics. An MRI may also be needed to evaluate the joint capsule for any damage such as tearing to the capsule itself. Because capsulitis can easily be mistaken in the forefoot for a neuroma, advanced imaging is very helpful in providing patients an accurate diagnosis.

Frequently Asked Questions

Yes. Any shoe that causes additional pressure and does not allow the capsule (especially at the MTPJ level) to function normally can cause capsulitis.

A custom made foot orthotic can help reduce pressure and realign the foot more appropriately to help encourage a more normal gait pattern. There can also be special accommodations in the orthotic to off-load the symptomatic area while the capsule heals.

Surgery is not generally a standard treatment option for capsulitis. Reducing the inflammation in any of the ways mentioned above is typically very successful. However, if the inflammation goes untreated and the capsular tissue tears, surgery may be needed to repair the torn capsule.