Capuslitis refers to inflammation of the tissues surrounding a joint. Capsulitis in the foot most commonly involves the joint tissue surround the second toe and the metatarsalphalangeal joint
The common location of this condition is generally related to increased pressures in the second metatarsal during heel lift while walking. Abnormal foot pronation (rolling in) and the relative increase length of this metatarsal compare to the other metatarsals puts at risk for injury.
Initial weight bearing to the bottom of the second metatarsal bone in conjunction with diffuse swelling on the top of the toe joint are usually noted. If untreated, the joint capsule or plantar plate on the bottom of the second metatarsal can develop at tear which creates instability of the joint leading to a hammertoe deformity. X-rays and MRI’s may be needed to assist in the diagnosis.
Treatment is aimed at decreasing the pressure on the second metatarsal during walking with the use of a supportive shoe and orthotic as well as the short term use of anti-inflammatory medications. An orthotic that is placed in the shoe typically will have padding to help relieve additional pressure on the second metatarsal bone. Anti-inflammatory medications including ice, NSAIDS like ibuprofen or naproxen as well as cortisone can be used. Cortisone must be used cautiously and in some instances can lead to the development of a hammertoe.