hey everyone I want to talk today about peeing
under the ball of the foot under this area here there are a number of different causes pain in
that area but what we're in talk about today is somebody called capsulitis which is the most
common cause of pain in this area now the if you look at these joints are these called the
metatarsal phalangeal joints and like all joints these bones are held together by ligaments now
the the ligaments that hold joints together are called a joint capsule this is a joint capsule
right here so if there's too much pressure on these areas then those that capsule can become
inflamed and damaged and the standard treatment initially is to get pressure off it we might
use an orthotic to get pressure off that area but sometimes that tissue just stops healing the
healing process itself stalled and we need to do something to stimulate that healing so there's
there's different ways to do it but probably one of the more effective ways is something called
shockwave therapy this is a shockwave machine here it's called extra corporal or outside the
body shockwave therapy in this handle is a little bullet that goes back and forth and that bullet
goes back and forth creates a pressure wave that comes out the head here and when that is applied
to tissue like a joint capsule it creates some biologic changes in that tissue basically takes
a non-healing tissue and stimulates a healing response and a couple things occur number one is
something called neovascularization or formation of new blood vessels second thing is released
or what are called growth factors these are proteins that stimulate healing now as every
treatment has it did this this term even has advantages and disadvantages the advantage to
it it's been shown on a lot of similar tissues to be very effective as stimulating healing it
can be 70 to 80 percent effective it's there's no risk whatsoever no one's ever worse for
having done shockwave therapy and it's for the most part pretty painless the downsides are
it's slow when it does work it takes about four months to see the benefit for it from it and
although it has been studied extensively on similar tissue such as the joint of the shoulder
there are no specific Studies on the metatarsal phalangeal joint the other downside it's not
covered by insurance it's not that expensive but you're probably depending where you are in
the country you're gonna spend between between about four hundred and six hundred dollars for
that treatment but it's a good non-invasive way to stimulate healing and tissue that is not
otherwise healing and certainly something to think about if you're having ball of
foot pain that's just not getting better