Capsulitis: Everything You Need to Know

Feb 23, 2022

Also referred to as MPJ, capsulitis. This condition causes a distinct aching, burning, and even at times a sharp transient pain in the ball of your foot.  This pain is most often felt just below the base of the second toe. It suggests that there is inflammation within the ligaments that stabilize the proximal phalanx on the metatarsal.

Simply put, capsulitis, occurs whenever the ligaments and plantar plate, comprising the capsule of the metatarsal phalangeal joint (MPJ), become inflamed by either injury or overuse. If you’re suspicious of a sharp pain felt in the ball of your foot, capsulitis could be the cause.

man with pain in foot

Capsulitis Explained

While they may look funny and a bit useless, our toes and associated joints go through a lot. Not only are they responsible for our balance, but they also bear the brunt of most of our movements. This is especially true whenever we are running or walking.

Sometimes, the joints at the base of your toes can experience large amounts of pressure and strain. As a result, inflammation can start to build around these joint structures. This condition is called capsulitis, or MPJ capsulitis of the foot.

The inflammation affects the metatarsal phalangeal joint at the base of the toe. The MPJ is crucial to movements like bending, stretching, and a host of others. Due to the body’s dependence on our toes for balance and movement, capsulitis can significantly restrict mobility if left untreated.

It is far more common for capsulitis to affect the second MPJ. However, the third, fourth, and pinky toe joints are not immune from this condition. As capsulitis progresses it can lead to the weakening of the ligaments and the stabilizing structures of the affected toe. Eventually, this weakness may lead to a tear resulting in a joint dislocation and a “cross over toe”.

What Causes Capsulitis

Capsulitis most commonly affects males and females between 30 and 60 years of age. It is caused by a strain that gradually builds on the metatarsal phalangeal joint. The ligaments and tissues holding the joint together become inflamed and if left untreated these tissues degenerate and weaken due to the increased stress and chronic inflammation.

Stress on the toes can build from a host of normal activities. You’ll find no shortage of ordinary movements that creates strain on the ball of your foot.

You may have been spending a lot of time climbing and balancing on ladders, for instance, or working in a squatted position balancing on the balls of your feet for hours. Working out with heavy weights, repeated lunging, rope jumping, and stair climbing can all create undue overuse.

In many cases, the stress inflicted by the frequent use of high-heeled shoes can lead to capsulitis. Ailments like rheumatoid arthritis can be causes as well. Capsulitis of the foot can also occur from physical and biomechanical issues of the foot like bunions, abnormally high arches, unstable low arches or abnormally long second toes.

Symptoms of Capsulitis

A burning or sharp pain in the ball of the foot is commonly experienced by patients with capsulitis. The pain is generally worsened when walking without shoes on hard surfaces like wood or tile floors.

Capsulitis may lead to your toe shifting positions as the condition progress. This deviation of the toe can ultimately lead to subluxation, and dislocation of the joint resulting in a “cross over toe” which makes walking and wearing shoes even more difficult.

Other symptoms of capsulitis include:

  • Swelling along the bottom base of the toe.
  • Feeling a “lump” in the ball of the foot while walking in bare feet on a hard surface.
  • Pain in the foot, which gradually increases throughout the day.
  • Pain normally goes away when off your feet.

If you or anyone you know experiences the symptoms listed above, it is best to schedule a consultation with a trusted medical specialist.

Capsulitis Treatment Options

Staying off your feet, regular rest, using ice, and wearing comfortable supportive shoes are methods known to help restore affected feet. This is generally the case whenever capsulitis is treated early.

Yet, capsulitis is known to progress quickly. This is especially true with excess activity. By the time you decide to consult a specialist about that sharp, burning foot pain that won’t go away, you’ve probably enhanced the symptoms through regular activity.

Some serious cases may require surgery. Yet, it hardly gets to this point if diagnosed early.

Non-Surgical Treatment

Non-surgical care focuses on reducing forefoot pressure, preventing further damage to the MPJ, decreasing swelling, and pain, and encouraging healing of the damaged tissues:

  • Avoid activities that increase weight on the ball of the foot.
  • Correcting the biomechanics of the foot and ankle .
  • Wearing supportive shoes and orthotics.
  • MLS Laser Therapy
  • Contrast baths to reduce swelling.
  • Anti-inflammatory medications help alleviate pain and swelling.
  • Using splints to keep the affected toe in proper position

It should be noted that the methods listed above do not address the structural damage leading to joint subluxation and dislocation caused by chronic neglected capsulitis.  These end-stage digital deformities of capsulitis are best treated with surgical correction.

When to See Us

Delaying proper care and treatment won’t help you at all. In fact, it might lead to severe damage of the MPJ capsule, increased symptoms, and toe deformities!

Contact us if you have any persistent or obstructive pain in the ball of your foot. We will be more than happy to get to the source of the problem and help you find the relief you need. Schedule an appointment with InStride Crystal Coast Podiatry by giving us a call at (252) 638-4700 or by filling out our online contact form.