Today on the Doc On The Run Podcast, we’re talking about what is capsulitis in the big toe joint.
Yesterday, I was seeing someone who is a long-time athlete and she had pain in the big toe joint and she was given a diagnosis of capsulitis. Well, I was seeing her for a second opinion and when we started talking, she was a little dismayed because she said that she was given this diagnosis of capsulitis and she felt a little bit like it wasn’t a real thing, it wasn’t a real problem, and I have talked about this some with other conditions like metatarsalgia where you get a diagnosis of metatarsalgia and that means basically pain somewhere in the area around the metatarsal, which is sort of like going to the neurologist and getting a diagnosis of a headache.
But unlike metatarsalgia, capsulitis really is a thing that is a diagnosis that is useful, and what I mean by that is that if you have a diagnosis of a headache, you don’t really know what you should do. Does that mean that your headache is caused by tension and you need a massage? Does it mean that you have a headache because you have a brain tumor? Does it mean that you have a headache because you had a concussion? What does it mean and what should you do? When you have a diagnosis of capsulitis in the big toe joint, it does mean you have a problem that you can address in certain ways to decrease the discomfort, start recovering and get back to running.
So capsulitis means you have specifically inflammation of the joint capsule, and in respect to the big toe joint, what that means is that you have either stretched or stressed or pinched the joint capsule and the lining of the joint capsule that caused irritation and is making it painful in your big toe joint when you run. The joint capsule is actually a pretty simple thing. You have a fibrous out covering that’s very tough and holds it all together and connects the bones in the big toe joint and it holds the fluid in to keep the cartilage lubricated and nourished. The lubricating fluid in the joint is called synovial fluid. When you have capsulitis, what happens is the synovial tissue that lines the inside of that joint and makes that synovial fluid actually becomes inflamed and it starts to swell.
Because you have a fibrous covering on the outside of the joint, the synovial tissue, when it swells, isn’t really capable of swelling outward because it has this fibrous covering holding it in place. So instead, that synovial tissue actually swells inward, and then you have this soft squishy tissue that has lots of nerve endings that starts to get sort of caught and pinched inside the joint when you move the big toe. So when you have capsulitis of the big toe joint, you’re actually getting discomfort because that soft squishy tissue on the inside of the joint is swollen and getting irritated whenever you move the big toe, push on the big toe or any of that sort of stuff.
So what you have to do when you have capsulitis address that inflammation. You have to do something to decrease the inflammation in the joint, and then your discomfort will actually start to go away pretty quickly. So there are lots of ways to do that, but it’s just important to understand that when you have capsulitis in the big toe joint, it is an actual condition that you can do something about. So you just have to get the inflammation in control and stop pinching and squishing that tissue while you’re trying to calm it down. If you do those two things, it really will calm down quickly and then it’ll basically be like it never happened so it’s not a detrimental kind of condition and it is a thing that you can easily do something about if you’re just trying to get the pain in your big toe joint to go away and get back to running as quickly as possible.
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