Do You Have Pain in the Ball of Your Foot? How to Diagnose and Treat Capsulitis

Do You Have Pain in the Ball of Your Foot? How to Diagnose and Treat Capsulitis

When you mention foot injuries, most people think of Achilles tendonitis, stress fractures or the dreaded plantar fasciitis. While these afflictions seem to be the most popular, especially among runners, it is possible that pain in your forefoot could be the result of another common ailment: capsulitis.

No, it isn't the name of a Greek war hero. Capsulitis is a condition that affects the joints behind your toes. These joints are covered in ligaments that form capsules to help keep your bones moving smoothly. If those capsules become inflamed then you have capsulitis. Although this can happen to any joint in your body, it seems to be most common in the ball of your foot, especially behind your second toe.

So how do you know if you have capsulitis? It can be a painful condition, often accompanied by swelling and redness in the affected area. Walking with the inflamed capsules will often feel like you're landing on a stone with every step. If left untreated, chronic capsulitis can lead to the formation of painful calluses that feel as if they have a core or seed inside of them.

According to Dr. Ray McClanahan, podiatrist at Northwest Foot and Ankle, capsulitis is often caused by excessive weight-bearing beneath the affected toe joint, but these factors can increase the likelihood of the inflammation developing:

  • Extreme bunion deformity.
  • A second toe that is longer than your first toe.
  • An unstable foot arch.
  • Tight calf muscles on your involved side.
  • Imbalance between the muscles on top of and below your feet (extensors and flexors).
  • Regular use of footwear with an elevated heel, tapered toe box and/or toe-spring.

Dr. McClanahan believes that toe springs (shoe designs that force toes to be held in an upward position) and tapered toe boxes may be the most common causes of capsulitis. Both of these features, often found in conventional shoes, alter the way weight is distributed on our feet when we walk. Toe springs increase pressure under the joints where capsulitis often occurs, and tapered toe boxes squeeze your toes together, often taking much weight off the big toe and distributing it to the second toe.

Toe Spring and Tapered Toe Box

The good news is that capsulitis can often be relieved with simple non-surgical treatment, especially if it is caught at an early stage. Here are Dr. McClanahan's recommendations for dealing with the condition:

  • Rest: reducing weight-bearing activities can help control your symptoms.
  • Ice: icing your affected area can minimize your pain and swelling.
  • Taping or Splinting: proper taping helps align your involved toe and prevents your toe from drifting.
  • Stretching: stretching may be particularly important for those who have tight calf muscles or foot extensor/flexor imbalance.
  • Anti-Inflammatory Agents: supplements or medications can help reduce pain and swelling.
  • Footwear Therapy: shoes with little or no toe-spring and wide toe boxes may be most helpful. Also, toe spacers like Correct Toes and metatarsal pads placed in your shoe can help return your foot’s fat pad to its rightful, protective location under your metatarsal heads.

Need a suggestion for shoes? Here are some of our most popular styles... all handcrafted in Oregon, USA:

soft-star-ballerine-flatsshop-dash-runamocsshop-hawthorne-chukkasoft-star-solstice-sandal

 

For more information on finding for shoes that allow your feet to move and develop naturally, check out our Barefoot Shoes Shopping Tips. Please remember that it is always recommended to seek the advice of a medical professional for an accurate diagnosis and treatment plan.

For more information: Dr. Ray McClanahan. "Capsulitis" Correct Toes (July 1, 2013)

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22 Comments

  1. juliana
    it is really hurting and its all around my feet
    Reply
    1. Elf Martin
      So sorry to hear that, Juliana. If simple home treatments and rest don't help then it may be time to seek a professional's advice.
      Reply
  2. Christophe Carlier
    Christophe Carlier
    Thank you for sharing, this article on relieving foot pain. Luckily, I have never had this problem even as a runner. My wife, on the other hand, has chronic foot pain and it is unfortunate because it can limit her in many things involving fitness and even work. Like you said, when you experience foot pain you should rest, use ice, stretch and even use anti-inflammatory agents. We went to a doctor a while ago but she has not really improved much. We will definitely look into going back to have her checked out again. Thanks!
    Reply
    1. Elf Martin
      You're welcome Cristophe! I'm glad you liked it, and I wish your wife the best of luck. I know how hindering and painful foot pain can be.
      Reply
  3. Laura Litty
    Good post. I like the breakdown of the factors and the specific approaches that can be undertaken. It is often a simple condition to treat, if caught early.
    Reply
  4. Elf Martin
    Thanks Laura!
    Reply
  5. Lauren
    I've been diagnosed with capsulitis. What are the best shoes on the market for this condition? Name brands? I currently wear New Balance 990's, but I need dressier shoes for church/work/date nights. Thanks!
    Reply
  6. Elf Martin
    Hi Lauren. We're not doctors, so we can't make any professional recommendations for a medical condition, but many of our customers tell us Soft Stars work great for treating capsulitis. Our Merry Janes, Metros and Ballerine flats can all fit dressier occasions if ordered in black. Otherwise, you may want to check out Dr. McClanahan's recommended shoe list: https://nwfootankle.com/resources/111-Shoe%20List
    Reply
  7. Lizzy Gold
    Wow! I have all of these symptoms and I never realized this was the problem. Unfortunately, I have to wear flats to work which I believe is the main culprit. What can I do to get them back in good shape? Great post!
    Reply
  8. Kiara Woodsland
    My son has been playing basketball a lot lately, and he's told me that he has had a lot of pain in his foot. I'm starting to wonder if he has capsulitis. Because he has a lot of those factors you mentioned. Including bunion deformity and the second toe being longer than the first. Maybe I should take him to a foot clinic, I don't want any more factors coming into play.
    Reply
  9. Daniel
    Hi,

    I had capsulitis and I cure it with COD liver oil supplements.
    I'm not saying it will work for you, but if someone else can try it and tell me if it worked?
    Not all COD liver oil works for me, just the Webber one. I was taking two a day and inflammation was gone in minutes. I was shocked.
    Try all the food with high anti inflammatory benefits, turmeric for example.
    At the end, it is just inflammation and it is very likely that you body is not converting or producing certain vitamin or mineral. I figure that out in my case.
    Being on the sun, getting the Vitamin D also helps.
    Reply
    1. Elf Martin
      Thanks for the tip, Daniel!
      Reply
  10. Daniel
    No problem.

    I got mine last October or November. I took break from running for almost a month, then started easy and it came back again. Forgot to mention that first thing that helped me was pressing and squeezing my lower back muscle(calf right?), after doing that it release pressure pain right away. Later I notice that COD liver oil from Webber and other food with rich anti inflammatory benefits helps. My gf was cooking me rice with turmeric for months haha. Now I just take one or two pills a day.
    I live in Canada and it may be related with sun(vitamin d) since we spend lots of time indoors and outdoors we are all covered with clothes.
    Just my two cents.

    I really hope it will help other people. I was reading cases where people were doing several surgeries, then they had cortison shots and other crazy stuff.

    Cheers
    Reply
  11. john  aiello
    For some time now I have been experiencing two calluses on the bottom of my forefoot. It is extremely painful and I usually scrape and remove the calluses with a sharp knife. I noticed when removing the hard skin of the calluses there appears to be a small stone in the center that was causing the discomfort. Once removing the stone I can then continue to walk without pain for about two weeks and at that time the whole process is repeated. Needless to say my wife gets extremely upset when she sees me doing this. How can I get ride of this permanently?
    Reply
    1. Elf Martin
      Hi John. Sorry, but we're not medical experts here and can only relay information and articles from doctors on this blog. You'll need to talk to a professional about this one.
      Reply
  12. Ashley
    This is exactly what I feel every day since I did either step on a rock (for real) or on a seed pod of a sweet gum tree. The ball of my foot has been sore ever since, especially when I take a step. Feels like I am stepping on the rock/pod every time. It hurts less when I walk on hard, flat ground, like pavement. Even in the house, it hurts. Could the inside of my foot be bruised??
    Reply
  13. Melodie Fournier
    This sounds like what I have. Except I'm experiencing terrible pain in my right calf also. I just ordered Hoka running shoes. Haven't been able to run which is what helps me keep my weight down. I just want to run again. Doctor says it is inflammation of my metarsal 2nd toe joint.
    Reply
  14. Jade Brunet
    I had never heard about capsulitis pain before reading this article. It is interesting to learn that it is a painful condition, often accompanied by swelling and redness. My sister has foot pain regularly and says that massaging the affected area of her foot helps her to stay on her feet.
    Reply
  15. Lorraine Thurlow
    Lorraine Thurlow
    Hi. I've had this problem for a few years. It feels like I have a stone strapped to the sole of my left foot. I never knew it had a name, not even when attending the Belmont clinic in England, supposedly one of the best in the country. All they gave me was foot inserts which didn't help and were very uncomfortable and needed bigger shoes. Eventually they made a bespoke one for me, it's expensive, they said, so make sure you use it! Well, it was hopeless, it didn't address the problem and they got cross with me.

    My husband (an engineer) got some kind of rubbery material from work, put it on the floor and cut round it. Then I drew all over the area of my foot with charcoal, stood on it and cut a hole where the charcoal stuck to it. So that's my foot insert now. But I have to have multiple corns removed by a chiropodist every month and it gets very sore, but not as sore as before. Now my right foot is going the same way. I'm really fed up.

    Cheers,
    Lorraine
    Reply
    1. Elf Martin
      Sorry to hear about your foot pain, Lorraine. I hope the tips in this article are helpful in finding a solution.
      Reply
  16. akshay ortho
    I have already ordered a pair of running shoes for work. I wore orthofeet's shoes all day, and had no foot pain. I have plantar fasciitis, metatarsalgia and neuropathy, and had no pain all day. The arch support is perfect, much more comfortable than my $400 orthotics. When they came in the mail, I immediately tried them on, couldn't believe when I stood up-- it was heaven!. I have been telling everybody I work with about these shoes.
    Reply
  17. MARGIE  MILLER
    The pain is on the side close to the right of the ball , down the center. looks like some thing is growing in it very inflame looking. I thought pain was because i needed pedicure .
    Reply
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