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Capsulitis: When Ligaments Get Hot and Bothered

You all know people who are short tempered. The least little thing can set them off on an angry, red-faced tirade. You may try to calm them, but they refuse to be soothed. A similar thing can happen to tissues in your body, too. Something “sets them off” and they set up a protective barrier to ward off the trouble. The tissue becomes red, hot, and inflamed. Capsulitis is such an inflammation that affects the ligaments around a joint. In your feet, it most often occurs in the second toe.

The Angry Joint Capsule

Your skeleton is made up of many bones that are joined together by ligaments. These joints allow you to move around by letting the bones move without becoming separated from each other and collapsing. It is the capsule of ligaments around the bones that holds them in place. Because ligament tissue is softer than bone, it begins to deteriorate sooner. This is aggravated when a lot of stress is placed on them.

Your foot has five joints where the long metatarsals of your midfoot join the phallanges (toe bones). These joints allow you to rise up on tip-toe, push off when walking or running, or curl your toes under to grip surfaces. The joints are held together by the plantar fascia ligament at the bottom and others around the sides and top. Often, the ligaments in the joint capsule of your second toe are stretched and stressed. They become inflamed, turning an angry red, swelling, and causing pain and loss of function.

Your Short Tempered Second Toe

If you spend lots of time on the ball of your foot, capsulitis is more likely to occur. This includes activities like gardening, standing on ladders, catching in a baseball game, or wearing tall-heeled shoes that force your weight on the forefoot. Wearing flimsy footwear can also cause your toes to bend more than they should and stretches the ligaments of those capsules.

The way your foot moves as you walk could be a factor as well. Bunions and hammertoes formed because of abnormal mechanics put pressure on various joints in your forefoot. Many people have a longer second metatarsal, so that joint feels the pressure more than the others during movement. You can hardly blame it for feeling out of sorts and angry!

Symptoms include a nagging pain in the forefoot and possibly a feeling of thickness or swelling. Inflammation could make the area red and hot, and it could conceivably cause pressure on a nerve as well, causing numbness or tingling.

Calm Down the Pain

Conservative treatments for capsulitis are quite effective. They include avoiding too-high heels or flimsy soled shoes that don’t support or cushion the forefoot. They also include resting from the activities that contribute to the pain. That’s tough news if your job requires stooping, working on the floor a lot, ladders, or dressy heels. There are ways to compensate, though, including extra padding, lower heeled shoes, cushioned mats, or custom orthotics that offload pressure from the hotspots.

Dr. Craig Thomajan and Dr. Shine John at Austin Foot and Ankle Specialists can help you with these treatment methods. We can also use cortisone injections or prescribe anti-inflammatory medications to help with the pain while the ligaments heal. It may help to immobilize the joint for a time as well. If hammertoes or bunions are contributing to the problem, we can correct them surgically to relieve pressure on the joint capsule.

Contact our Austin, TX office by calling (512) 328-8900 or using the appointments tab on our website. We practice excellence in podiatry and will help you find answers to your pain. Don’t hesitate! Call us today and cool down your hot-and-bothered toes!

Most people who have searched this content have also found The Many Causes of Pain in the Ball of the Foot helpful.


Dr. Craig H. Thomajan
Founder and Managing Partner of Austin Foot and Ankle Specialists