Capsulitis and Foot Pain

My feet are still not functional after a month of rest. I do, however, finally have more precise answers. The second specialist I saw diagnosed me with severe capsulitis, especially in the second metatarsophalangeal joint. Theories abound about how it happened. The main thing now is getting it fixed so I can first walk, then hike, then run again.

The pain of capsulitis is like nothing I’ve ever felt. Through all the years of spinal issues, chronic pain, and other health problems, nothing compares to capsulitis. My right foot is now the worst, although it started out opposite. Luckily, the pain is starting to localize a bit and is primarily focused on the joint capsule of the second metatarsophalangeal joint.

Through many sleep-deprived nights (I’m an insomniac anyway, but the nighttime pain in my feet has been unbearable), I’ve done a ton of research on capsulitis. There are a ton of theories out there, and as is often true with health-related information, a lot of the theories directly contradict each other. One example is in footwear. Many podiatric and orthopedic websites (and doctors) swear by a rocker sole for a shoe, while some decry traditional shoes as part of the problem. As with all things, it’s best for me if I gather information and opinions and then form my own plan.

Shoes for Capsulitis

Since I already run in zero-drop, wide-toebox shoes, I’m definitely a believer in natural foot motion and foot strength. I think it’s possible that my capsulitis developed from walking in more traditional footwear: i.e., the kind with toe spring and a major heel-toe height differential. For those who’re clueless like I was, “toe spring” is the amount of upward turn in the toe are of the shoe. If you think about it, that really is an unnatural, weird position for the human foot, which is meant to be flat on the ground when standing.

Debilitation of Foot Pain

The pain, swelling, and dysfunction in my feet go so bad that capsulitis landed me in a wheelchair. It was almost surreal to be pushed around the park in a wheelchair because of foot pain. The fresh air and change of scenery was great, but it was unbelievably frustrating to be in a chair for what seems like a ridiculous reason. The capsules that’re causing this misery are tiny, but holy crap are they sensitive. 

Solutions for Capsulitis

metatarsal pad for capsulitis
The red-pink, pacman-like outline is for the custom metatarsal pad my doctor made to treat my capsulitis. He used a cutout at the top to give extra room for my swollen joint capsule.

One of my coworkers helped me tape custom-cut (courtesy of a wonderful podiatrist), firm felt metatarsal pads into the metatarsal arch area. By elevating and supporting the metatarsals, plus wearing flat, zero-drop shoes, some of the pressure is taken off the capsulitis. I’m able to hobble-walk with a borrowed rollator, which isn’t awesome, but it’s a hell of a lot better than being in a wheelchair due to foot pain.

capsulitis pain runner
Capsulitis is extremely painful. I’m using a rollator so I can get some upper body and core workouts done while I can’t walk or run.

I’ve been good about doing upper body and core workouts throughout this nightmare, but it’s demoralizing and depressing to be unable to walk, run, or hike. A major trip was postponed and I began to reach a scary level of depression and hopelessness. Throwing everything at capsulitis—ice baths, epsom salt baths, CBD oil, ibuprofen—and getting no results was crushing. My auto-immune specialist called in a prescription for a Medrol dose pack. Steroids aren’t necessarily standard treatment for capsulitis, but I was desperate and he was quite worried about the raging, long-lasting inflammation. I’m on day three of the steroids. They’ve made me a bit more emotional, they’re slowly helping clear up the agony of capsulitis. 

One thing I’ve become conscious of is my toe position. It seems that for some time, I’ve been walking with my toes bundled together. I think I’ve been running that way, too, but I’m not sure. I have no idea why that’s happening, other than weak intrinsic foot muscles and tight extensors in my feet. I found a website with a wealth of information about all things feet, and I highly recommend checking it out if you’re suffering from capsulitis or any other foot malady. There are a ton of informative videos available for free, especially on common complaints such as plantar fasciitis. Click here to get to the the video library of all things foot-related. 

The next phase of the plan to heal my capsulitis is more of the same for several more days—rest, elevation, gentle stretching of the extensors, and gentle foot mobility exercises. I’ve never been this sedentary in my whole life, but it’s necessary for now. The core and upper body exercises are keeping me a little bit sane. In a few days, I go back to my auto-immune specialist, and then back to the podiatrist. I’ll be done with steroids by then and really, really hope to feel good enough to declare capsulitis a thing of the past. For now, I’d be over the freakin’ moon if I could just take a few normal, pain-free steps. Capsulitis sucks big time and I never want to go through anything like this again.

Transverse Arch Dysfunction

feet in ice bath for transverse arch pain
I can’t stand cold and have to be careful because I have Reynaud’s, but the ice baths have helped bring down the inflammation in my feet.

My stellar run in new shoes turned out to be not so stellar at all. Despite feeling fine during the 6.25-mile run, and fine during a walk later in the day, I woke up the next day with sore feet. Those sore feet turned into agony and debilitation when I tried to to walk to the park near my house. Within a quarter mile, I had to stop. I couldn’t even get myself home and had to call for a ride. My feet felt like something was tearing off the bones in the space between my metatarsal heads and my toes.

I had no idea what was going on and had never felt such pain before. Perhaps scariest, the burning, tearing sensation was in both feet. I only felt it during push-off in the gait cycle, but of course that’s a major component of walking and running. I discovered that if I took off my shoes and socks and walked barefoot, I was pain-free. But as soon as I put on shoes– any shoes, regardless of model or style– the bilateral foot pain was so intense I couldn’t take a single step.

Transverse Arch Pain, Not Plantar Fasciitis

After extensive Googling that consistently turned up results for plantar fasciitis even though plantar fasciitis didn’t make sense with my symptoms, my fear and discouragement grew. I co-taught anatomy & kinesiology at our local community college for four years, but still couldn’t figure out what was going on with my feet. I pulled out the two textbooks I kept from my teaching days and still couldn’t quite make sense of what I was seeing. The internet definitely wanted to convince me that I had plantar fasciitis, but I knew that wasn’t right. I started wading through information on the structures of the foot and paid particular attention to the transverse arch. Bingo. The transverse arch essentially runs through the foot rather than along its length. I honestly didn’t even know the transverse arch existed until it caused me some of the worst pain of my life.

I’ll spare the details of a very intense eighteen days, but suffice it to say that the last couple weeks and days have been terrible. With the help of other practitioners, including an orthotist, we decided my hunch was right about the transverse arch in each foot. I tried everything, spent a ton of money on shoes (most of which I returned), used supportive insoles, and nothing helped. The insoles made me even more miserable because they were so rigid and high that my longitudinal arches and heels started to ache. The orthotist showed me metatarsal pads, which are essentially hard little pieces of foam that look like large guitar picks. If placed behind the metatarsal heads, the pads should support the transverse arch. I took the little pieces of foam home with renewed hope that I could at least walk from one room to another without agony.

In Search of Metatarsal Pads

The met pads (lingo, so I’ve discovered, for metatarsal pads) were a new kind of misery, but they had potential. Unlike the full-length insoles, the met pads targeted one problem area, the transverse arch, rather than trying to rework the entire shape and mechanics of my feet. I sanded down the hard foam to make them not so intrusive, but they still felt like smooth rocks under my feet.

A trip to Walgreens for something to support my transverse arches was a bust, but CVS provided a little more hope. I bought a package of thin, soft foam metatarsal pads. They were much larger than the met pads from the orthotist, but I cut them down with my old EMT scissors until they were the same shape and size as the hard foam ones. I put one in each shoe, and after a lot of misery and trial and error, was finally– after two weeks– able to walk semi-humanlike. The thin foam must’ve been just enough to support my transverse arches without feeling like I was walking on rocks.

homemade metatarsal pads
The remnants of my homemade metatarsal pads for transverse arch pain and dysfunction.

After a day, though, the pain got worse again, even with my homemade met pads. I realized that the cheap foam must’ve compressed too much and not rebounded, even though I’d probably walked only a total of a quarter mile on the pads. I cut another set and doubled them on top of the originals and began moving somewhat humanlike again. Transverse arch pain is no joke! This is some of the worst pain and debilitation I’ve ever experienced, even beyond the years of back and neck issues I’ve suffered.

Followup with the Doc

As things stand now, I’m heading back to the doctor tomorrow for an updated plan. I haven’t run in almost three weeks and can still barely walk, but the left foot seems to be improving. The right foot is the worst, which is weird because it started out better than the left. I have all kinds of ideas for inexpensive ways to custom-build some met pads for myself and will likely take a trip to Home Depot and/or Michael’s tomorrow to buy industrial foam and craft foam. Medical supplies are marked up so high, but it’s easy to find workable materials other places that will stand in just as well as the so-called specialty medical crap.

I’m very worried about my feet, especially the right one, but worry and anxiety only contribute to pain, so I’m trying to chill. I have newfound knowledge about the transverse arch, but I wish I never had to know anything about it. Here’s hoping tomorrow’s doctor’s appointment is worthwhile and helpful. I’m going crazy without running, walking, and hiking.