How can I tell the difference between capsulitis and a neuroma?

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[@crispycruiser4654]

My symptoms feel a lot like a neuroma and based on the location but after reading some resources (and your video seems to corroborate) it seems unlikely. One podiatrist wrote a paper saying the incidence in his office is 30 to 1 capsulitis over neuromas. I have pain in between the 3rd and 4th toe, higher up near the proximal interphalangeal joints. I do not pass the click test but it is very tender to palpation and localized, which leans more towards a joint problem than a nerve problem. I got it from doing too many heel raises in PT and it is going on 8 weeks now. I cannot believe how long such a tiny ligament takes to heal. I could've healed from a nondisplaced fracture faster than this. Incredibly frustrating.

[@GoToFootDoc]

If you do not feel a shooting pain or numbness extending into the toes after compressing the 3rd interspace it is most likely from the joint(s). This can be very difficult to heal without treatment. If the joint/plantar plate has been damaged it will not heal without treatment. Just to muddy the waters - you can have both problems at the same time. If the joint swells it can compress the nerve.
I agree with the incidence of caps vs neuroma.

[@crispycruiser4654]

@@GoToFootDoc I appreciate your reply. No shooting or numbness at all. Just a localized ache. It is extremely difficult to treat as I have learned and I have it in both feet. One of them is making progress after 2.5 months. The other is a little over a month in and has not improved at all. There is no swelling or redness in either of them so I don't think it can be that severe, and definitely non-operative, but very pesky. Spoke to someone on a running forum who said it took a year to heal. When you say treatment is it just your standard rest/offloading/orthotics/NSAIDs? I can't do cortisone due to a long history of tendonitis and tendon rupture. Feels like getting an MRI is useless as I've had two false negatives in a row for more severe injuries (Achilles tendonitis/bursitis and plantar fasciits but not caught)

[@GoToFootDoc]

@@crispycruiser4654 If the plantar plate is not damaged, this should be responsive to effective offloading. The key is effective.

[@ozeldicle]

This is very helpful. I'm based in Philly and my podiatrist is currently tring to figure out if I have a neuroma or capsulitis. The pain is located on my 4th -5th toe area and it feels more like what you described as capsulitis. I just got a steroid shot and it has been 2 days but I see no difference, I hope it works. Is tehre anything you recommend that I can do myself? Thanks!

[@GoToFootDoc]

Keep an eye on when the discomfort occurs (exact location)- what activity, duration of acclivity before symptoms and how long it lasts. This info will be helpful at your next visit. Rocker bottom shoes will help offload the forefoot and probably help either problem.
Good luck!

[@ozeldicle]

@@GoToFootDoc Thank you so much for the response! The steroids seemed to have calmed things down, after a flare up reaction, I have been keeping a diary myself. Do you find that capsulitis pain goes away in time? especially with steroids?

[@GoToFootDoc]

The dose pack will make it better for a while but the cause needs to be addressed for long term results. Usually off loading the offending met head does the trick. Glad you are doing better.
. @@ozeldicle

[@crispycruiser4654]

@@ozeldicle How's it feeling 6 months later?

[@Xoxo-mwahhh-Xoxo]

What if it’s on my big toe not my 2,3,4 or 5th toe?

[@GoToFootDoc]

It is the same principle of overloading a joint. It can occur under any metatarsal. The big toe has 2 gliding bones called Sesamoids that can add to the problem.

[@ИринаКрылова-х1ж]

Перевод нужен

[@GoToFootDoc]

Thanks... I think