MTP Synovitis (Capsulitis)

MTP synovitis (capsulitis) is a sharp or aching pain in the ball of the foot, usually beneath the base of the second toe. This pain occurs when the proximal phalanx, a bone in the toe, separates from the long bone in the foot (metatarsal).


Overuse and stress on the joint at the base of the toe is the primary cause of MTP synovitis (capsulitis). When this occurs, the ligaments and tissues that hold the joint together begin breaking down and become inflamed. Stress can be the result of any activities that put an excessive strain on the ball of the foot, such as climbing stairs or squatting. Other factors like rheumatoid arthritis or wearing high heeled shoes can also lead to capsulitis of the foot.


Pain in the ball of the foot, usually beneath the second toe, is the most common symptom of MTP synovitis (capsulitis). Patients experience a burning or aching pain that is worse when standing, barefoot, and walking on hard surfaces. As symptoms progress, the structure of the foot may shift and walking will become more difficult. “Crossover toe” can occur in severe cases, which is when the toe moves out of position and crosses over the big toe.


Physicians will diagnose MTP synovitis (capsulitis) by asking about symptoms and examining the foot for pain and structural abnormalities. Imaging tests such as x-rays may also be used to rule out other injuries to the foot.


If addressed early, MTP synovitis (capsulitis) can usually be treated with rest, taping, splinting, icing, and anti-inflammatory medications. Walking boots and aids, such as canes or crutches, are also effective. If pain persists and the toe is still deformed, surgery may be required.

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