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Capsulitis
from: Dr. Jeffrey A. Oster, Medical Director Of Myfootshop.com.Capsulitis is an inflammatory condition that can occur at any joint, but most frequently effects the foot beneath the forefoot. Inflammation of the joint capsule of the forefoot can be caused by systemic diseases but is most often caused by excessive mechanical load being applied to the forefoot. The most common site that capsulitis occurs is beneath the second metatarsal head.
Treatment of capsulitis
The first step in treating forefoot capsulitis is to find ways to off load the forefoot. Off loading is a simple technique that can be achieved in many different ways. Pads and cushions are by for the most popular ways to off load the forefoot. Metatarsal pads are also a common shoe modification used to off load. A trip to any shoe repair shop will be a valuable lesson for anyone with forefoot capsulitis. The shoe repair shop can explain the size, placement and logic behind the use of a metatarsal pad. Shoes can also be used to off load the forefoot. A simple example are clogs. The rocker sole on clogs has been used for years to off load the forefoot. Orthotics are another method of off loading.
Should the methods mentions for off loading fail to relieve the pain, an injection of cortisone can do wonders. It's important to realize that capsulitis is typically a mechanical problem caused by focal loading on one metatarsal head. Logic says that off loading is necessary. Cortisone approaches the problem from a little bit different direction. I often compare a shot of cortisone to throwing a wet blanket over the fire without actually knowing why there's a fire. But the bottom line is that it helps. In many instances, a shot of cortisone can make a problem of capsulitis disappear indefinitely.
And lastly, surgical procedures may help. In particular, a metatarsal osteotomy can be used. An osteotomy is a surgical fracture in the metatarsal bone to raise the metatarsal head up and away from the ground.
About the Author
Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster is also board certified in pedorthics. Dr. Oster is medical director of Myfootshop.com and is in active practice in Granville, Ohio.
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