capsulitis
Displaying items by tag: capsulitis
Dr. Brandon Nelson, Board-Certified Foot and Ankle Physician and Surgeon, Discusses Forefoot Capsulitis
Capsulitis refers to a large group of conditions that is associated with inflammation of the joint capsule. It is important to have a little bit background of anatomy in order to understand this pathology. The joint is where 2 bones come together and these 2 bones are covered with articular cartilage and then these 2 bones are encapsulated by the joint sac that is full of fluid or hyaluronic acid. These all work in tandem to provide functional smooth gliding joint. There are many causes of capsulitis, basically it is just inflammation of the joint capsule itself.
Dr. Timothy Young, Board Certified Foot Surgeon Talks About How His Capsulitis of the Second Toe Was Treated
Capsulitis of the second toe and the second MTP joint is one of the more common conditions that we see and treat. Much of this problem is mechanical in nature. Some it has to do with the foot structure itself and it can also be an overuse injury. There is essentially too large a stress load going to this one joint (2nd MTP) disproportionate to the adjacent joints. The traditional treatments that are still critically important include prescription orthotics and good shoes that have forefoot rocker such as a Hoka shoe or Altra shoe. Other treatments include stretching the calf with a night splint and there are other treatments such as taping.
This can be a chronic and frustrating condition to treat. For the most intense problems where there is inflammation of the capsule we often consider adjunctive treatments. One of the simplest treatments that can be done that does not involve an injection is shockwave therapy. The goal of the shockwave therapy is to do intense treatment and the body essentially receives this treatment and believes there has been more trauma. The body reacts by increasing the blood flow to the local tissues including the capsule.
Also some the local healing factors, become more available to this tissue. This is very similar in some ways to other treatments that help the body regenerate. There are other treatments that can be done such as injections. Injections of Supartz which is sympathetic joint lubricant can be very helpful especially if some of the problem is actually intra-articular and not just the capsule but inflammation and pain of the actual joint itself including cartilage pathology and degenerative joint disease. Other injections may include Traumeel which is a non-cortisone based anti-inflammatory. In severe cases the plantar plate can be damaged an MRI may be indicated. These cases often require surgical repair.
Give us a call at 425-391-8666 or make an appointment online today.
Dr. Timothy Young Discusses Stubborn Capsulitis
I have had this condition myself. We are talking about capsulitis of the second metatarsal phalangeal joint (MTP joint) in the ball of the foot, near the base of the second toe. There have been previous blogs about the potential cause of this problem. Treatment has to address the underlying cause and foot structure as much as possible. If the calves are tight, then they have to be stretched and use a night splint or even have a gastroc recession surgery. If there is a bunion and the whole first metatarsal is not bearing is fair share weight then it can cause stress overload to the next in line second metatarsal. Orthotics and foot taping often help this.
Sometimes it's not enough and sometimes especially if there is damage to the capsule such as the plantar plate, we then have to correct the bunion and consider surgery on the second metatarsal. But there are other cases that don't require surgery. It still imperative to do all the other treatments. The correct shoes with a forefoot rocker, sometimes zero drop shoe such as Altra Shoes can also help. Avoiding the activity that seems to aggravate this also can be critical. For example, if you're runner or speed walker, you may have to put that on hold or do cross training until her symptoms have completely resolved. For myself, this seemed to come on after I had resumed running after several months off. I had to make sure my orthotics were still appropriate for this problem. I wore correct shoes. I had to stop running and cross train. I worked on stretching my calf and I have a night splint also.
If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today.
Dr. Brandon Nelson, a Board Certified Physician, Discusses Capsulitis/Metatarsalgia
Capsulitis/metatarsalgia is a term we use to describe inflammation of the forefoot. It specifically refers to inflammation of the joints in the front of the foot. This condition is usually associated with an underlying foot pathology like a bunion, an elevated bone or a tight calf muscle. This foot structure is usually inherited but can be brought on by injury.
Patients often describe a burning or swelling at the base of the toes and it gets worse with activities. Often patients will state they rub their feet and it feels better or even ice and notice some improvement. Tingling or numbness is another description we often hear. This sometimes improves with shoe removal.
The cause is usually from genetics, foot structure and mechanics. From a genetic standpoint there is often a bunion that is inherited or a flatfoot. The foot structure aspect is typically a long second metatarsal or an elevated 1st metatarsal. Mechanics can play a large role as well with tight Achilles tendons or increased pronation.
Treatment consists of addressing any contributing factor. I like to focus on the mechanics and foot structure specifically. An x-ray is helpful along with a detailed physical exam. If you are suffering from tingling, burning or swelling in your feet, or think you have capsulitis/metatarsalgia we can help.
Give us a call at 425-391-8666 or make an appointment online today.
Dr. Timothy Young a Board Certified Foot Surgeon, Talks About Surgical Treatment of Capsulitis of the Second Toe and a Bunion Deformity Combined
Surgical treatment for this condition involves correction of the bunion deformity, which often helps the second MTP joint capsulitis. The ideal procedure for this would be fusion of the first metatarsal-cuneiform joint in combination with the bunionectomy (lapidus bunionectomy or lapiplasty). The fusion of the first metatarsal stabilizes the first metatarsal and therefore able to bear the weight that it should be proportional to the rest of the foot. Therefor this procedure takes some of the stress off of the next in line 2nd metatarsal. So a lapidus bunionectomy is often a very effective treatment for both the bunion and capsulitis of the 2nd toe.
Dr. Brandon Nelson, A Board Certified Physician, Discusses Capsulitis of the Second Toe
Capsulitis is an inflammation of a capsule or joint. Your joints are defined by where two bones come together and have cartilage on the opposing surfaces and a joint sac (capsule) that encircles the two ends of those bones. Additionally in the joint capsule is fluid which helps the joint to glide smoothly.
The human body has many joints, the human foot has the highest concentration of joints with 33. The foot is an extremely complex structure and small deviations in the alignment can cause significant problems.
Capsulitis can have many causes, one of the most common is abnormal wear of a joint. Abnormal wear of a joint is usually attributed to increase pressures in that joint and can ultimately lead to arthritis. In the foot instability of the big toe can increase pressure in the 2nd toe leading to inflammation of that joint, the 2nd metatarsal phalangeal joint or MTPJ. What is typically seen is a patient with a bunion or a flat foot that causes results in high pressures of the 2nd MTPJ and the net result is pain. The pain can present with swelling, numbness or tingling. The eventual progression of this can lead to dislocation of the toe or what we call a cross over toe.
If you have pain around the second toe, icing and stretching can be very helpful. However it is important to have your foot evaluated as this is usually a progressive deformity that can cause increasing discomfort and eventual structural changes. I recommend an x-ray and an overall foot exam. Often times there are great conservative options to help this condition and help patients return back to activities. If you have 2nd MTPJ pain give us a call at 425-391-8666 or make an appointment online today.
Dr. Timothy Young a Board Certified Foot Surgeon, Talks About Capsulitis of the Second Toe and a Bunion Deformity Combined
This is a common combination.
When this happens in the first metatarsal does not carry its fair share of weight. It is common, for the next in line 2nd metatarsal to develop a stress overload. We can evaluation both conditions with an x-ray. We sometimes use an MRI to evaluation the extent of the 2nd toe capsulitis including for a capsular tear or plantar plate tear. Both the bunion and the 2nd toe capsulitis can be a difficult combination to treat.
The best bunion treatment can involve shoes and orthotics can also help with non-invasive bunion treatment. Bunion treatment options may be limited in severe cases and often need surgical treatment.
Dr. Brandon Nelson Discusses Ball of Foot Pain, Neuromas and Capsulitis
It is very common for our clinic to see patients that present with pain in the front of their foot. Often times patients have been dealing with this condition for months. Most patients will describe a burning or a feeling of walking on a bubble or that their sock feels balled up. There is usually no underlying injury and many patients will have a bunion with this foot type as well. The two most common diagnosis that encapsulate forefoot pain are 1. Capsulitis and 2. Neuromas.
Capsulitis refers to a general inflammation of a joint or a joint capsule. All joints are defined by where two bones come together, that share a common joint capsule with fluid inside and both bone ends are covered with cartilage. This joint capsule, fluid and cartilage allow gliding or motion to occur. Whether the joint is being overloaded or stressed can cause irritation, swelling, pain and sometimes stiffness. The most common spot for this to occur in the lower extremity is the second metatarsal phalangeal joint. This can be quite painful and make walking and exercise difficult. Most patients with this condition have an underlying unstable foot that causes the joint to be overloaded. It is important to see your foot and ankle doctor as this condition can lead to dislocation of the toe and chronic pain.
Neuromas are an irritation of the digital nerves of the foot. Most commonly patients describe a burning or lump in the front of the foot. This pain is often worse in shoes. The neuroma is usually between the 3rd and 4th toes and more often in females than males. We do not often see an underlying condition that causes neuromas. This is usually the result of ones anatomy and not related to the overall structure of the foot. Your foot and ankle doctor can typically diagnosis this with a physical exam and an x-ray or ultrasound.
If you are suffering from ball of foot pain, capsulitis or neuromas we can help. We combine the most advanced treatment options available with recent literature and have seen great relief from conservative measures. Do not continue to suffer call us today and we can help.
Give us a call today at 425-391-8666 or make an appointment online.
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