Capsules have all sorts of interesting uses. Time capsules describe life at a point in history. Space capsules protect astronauts as they travel. Pill capsules provide different ways of dispensing a medication. The capsules in your feet are a bit different in that they are networks of ligaments rather than outer membranes, but they do surround the joints of your middle toes to protect and hold them in place. Bottom of foot pain can indicate that you have developed capsulitis, which just means that these ligaments have become inflamed.

Metatarsalphalangeal Joint Capsules, Unite!

You have five joints in each foot where your metatarsals (long foot bones) meet your phalanges (toe bones), and each has a system of ligaments around it that hold it together. These capsules can become inflamed from excessive pressure on the ball of your foot. A common culprit is having an abnormal foot structure, where your bones don’t move together properly. This can happen because of bunions, a long second toe, an unstable arch, and even tight calf muscles.

With capsulitis you can expect bottom of foot pain, especially by the base of the second toe; swelling at the base of the toe; discomfort when walking barefoot; and trouble finding shoes that don’t hurt your feet. If the condition is not treated, it gradually worsens and can lead to even more deformity, such as displacement of the toes or a second toe that moves over your big toe (crossover toes). What you need is for the ligaments to heal and unite to form a strong covering for the joint that keeps your bones in place.

Similar Symptoms, Tricky Diagnosis

Pain under the bottom of your foot can be from many causes. One condition that mimics capsulitis is Morton’s neuroma—a thickening of the nerves that run between the middle toes. You could also have a stress fracture in your forefoot, or a condition called sesamoiditis. It is important to know exactly why your feet hurt, so you need the help of experts like Mark Gasparini, D.P.M. to diagnose what is wrong.

We will examine your foot thoroughly, including moving the toes and pressing on different spots in your feet to see exactly what is causing the pain. We may also use imaging tests like X-rays, CT scans, or MRIs to rule out fractures or identify any soft tissue damage.

Treatments for Bottom of Foot Pain

Once we have narrowed down the cause, we can suggest the best therapy for your situation. It may be something as simple as resting, icing to reduce swelling, and prescribing pain relievers to reduce pain until the capsule has healed. We can also prescribe an anti-inflammatory medication as another way to help decrease pain. Another option for treatment can be physical therapy which can often help decrease pain.

We can also show you stretches to help loosen the calf muscles and reduce the pull on the structures of your feet. Avoiding shoes that put pressure on the ball of the foot—like high heels—and wearing cushioning inserts or metatarsal pads can also help.

Many of our patients find good results from shoe modifications, like stiff-soled shoes that keep your joints from excessive movement. Custom orthotics that address imbalances in your foot structure and redistribute pressure away from the capsules may also benefit you. As a last resort for crossover toes, surgery may help correct the toe positions.

Don’t swallow the idea that pain is normal and unavoidable. Capsulitis can be treated. Give Mark Gasparini, D.P.M. a call in Massapequa, NY at (516) 804-9038. Follow us on Twitter and Facebook for more information on dealing with your foot pain. We are here to help!