Metatarsophalangeal Joint Capsulitis Overview
What is Metatarsophalangeal Joint Capsulitis?
The joint where the toe meets the foot is referred to as the metatarsophalangeal joint. This joint is surrounded by a membrane and a set of ligaments called a “capsule”, which helps the joint to function properly. Capsulitis is a condition in which these ligaments and the surrounding tissue have become inflamed. Although capsulitis can occur in the joints of the 1st through 5th toes, it most commonly affects the second toe.
Metatarsophalangeal joint capsulitis can cause considerable discomfort and if left untreated, can eventually lead to a weakening of surrounding ligaments that can cause dislocation of the toe.
Metatarsophalangeal joint capsulitis is also referred to as “predislocation syndrome”, a common condition that can occur at any age.
What Causes Metatarsophalangeal Joint Capsulitis?
- Abnormal foot mechanics, where the ball of the foot beneath the toe joint takes an excessive amount of weight-bearing pressure
- Bunion deformity
- Long 2nd toe (longer than big toe)
- Tight calf muscles (Ankle equinus)
What Are Some Symptoms of Metatarsophalangeal Joint Capsulitis?
Symptoms may include:
- Pain on the ball of the foot. It can feel like there’s a marble in the shoe or a sock is bunched up
- Swelling and pain at the base of the toes (underneath the toe)
- Difficulty wearing shoes
- Ladie may have difficulty wearing high heel shoes
- Pain when walking barefoot
- Unstable toe where the toe drifts toward the big toe and eventually crosses over the big toe “crossover toe”
Metatarsophalangeal Joint Capsulitis Diagnosis
An thorough physical exam in essential to diagnose metatarsophalangeal joint capsulitis. Symptoms of capsulitis can be similar to those of a condition called Morton’s neuroma, which is treated differently from capsulitis.
- X-rays are usually ordered, and other imaging studies such as MRI are sometimes needed.
Non-surgical Treatment Metatarsophalangeal Joint Capsulitis
The best time to treat capsulitis of the second toe is during the early stages, before the toe starts to drift toward the big toe.
The following treatments options are for early treatment of capsulitis:
- Rest and ice the area
- Oral medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen.
- Taping/splinting the toe
- Stretching exercises for patients who have tight calf muscles
- Supportive shoes with stiff soles to lessen the amount of pressure on the ball of the foot.
- Orthotic / Custom shoe inserts to distributes the weight away from the joint
- Topical pain relieving gel
When is Surgery Needed of Metatarsophalangeal Joint Capsulitis?
Once the second toe starts moving toward the big toe “crossover toe”, surgery is needed to reduce the deformity