Condition Spotlight: Synovitis

view of sole of foot showing where synovitis can occur

What is synovitis?

Synovitis is inflammation of the joint capsule, which is made up of a tissue called synovium.

When the synovium is put under too much load or pressure, it often responds by thickening or becoming inflamed.

In a normal joint, the synovium holds synovial fluid inside of it, which is essentially lubrication for the joint.

When synovitis occurs, this process is disrupted, which often leads to pain at the affected joint.


Which joints can be affected by synovitis?

Synovitis can occur in any synovial joint in the body, however, within the foot, it most commonly affects the 1st and 2nd metatarsophalangeal joints (MTPJs).

This is due to the high amount of pressure placed through these joints when we walk.

In a person with a ‘normal’ gait, they will “toe off” through the first and second MTPJs.  In other words, this is the part of the ball of the foot that you propel yourself forwards with.

For this reason, they are exposed to a high amount of pressure and are at an increased risk of developing synovitis.


What causes synovitis?

Synovitis is caused by repetitive trauma and excessive pressure on the joints.

This can be caused by a number of factors such as inappropriate footwear and high impact activities.

It can also occur in conjunction with other conditions including osteoarthritis and bunions.


What does synovitis feel like?

Synovitis can cause a sharp pain within the affected joint.  The pain will often worsen with exercise and tends to ease during rest.


How is synovitis treated?

Synovitis is treated by reducing the pressure that is going through the affected joint.

To do this, in addition to reducing the pressure, we need to reduce the pain.  This pain reduction may be achieved by applying padding to the foot with cutouts in them.

This provides space between the foot and the ground at the painful locations  and offloads the painful region.

This treatment may be combined with the use of non-steroidal anti-inflammatory drugs or icing to reduce the pain.

Short term adjustment to activity levels may be required to help treat your synovitis.

Once pain has been reduced in the short term, it is important to permanently have something in place that alters your foot’s function. This helps to prevent you overloading the injured joint in the future again.  Often, this will be achieved with orthotics.

The changes orthotics make to the function of your feet will depend on your individual foot type and requirements. Common ways the pressure may be relieved in the injured joint includes increased arch support, correcting the rear foot or having permanent forefoot offloading.   A small device known as a met dome can also be applied to orthotics or the insole of the shoes to help redistribute the pressure equally across the ball of the foot, rather than increased pressure at one site alone.

In severe cases, where conservative treatment options fail, surgery can be another way to treat this condition. However, it is important to trial less aggressive treatment options first.

If you’re experiencing pain in the ball of the foot, book an appointment with us today, so we can ensure you have the best treatment pathway possible.


How can you prevent developing synovitis?

One way you can avoid synovitis from developing is by not increasing your physical activity levels too quickly.

For example, if you start a running program and begin to stack on the kilometres straight away, tissues such as the synovium of the MTPJs are not ready for so much stress all at once, which means something is going to give.  Try not to increase your exercise levels by more than 10% per week. So, if you run 10km across one week of running, do not exceed 11km the next week.  This will drastically reduce your chance of developing synovitis or any other injury.

Another way you can prevent synovitis is by ensuring that you wear supportive footwear, especially if you’re going to be completing a lot of running or walking.  You need shoes that have support and flex in the right areas to allow your foot to function correctly.   If you need advice on finding the right footwear or runners, you can book an appointment with us.

Finally, if you are experiencing any pain in the balls of your feet, come and see us as soon as possible. The earlier we get onto conditions like synovitis, the easier they are to treat and recovery will usually be quicker.

Call us on (03) 9432 2689 or book an appointment online.


Aaron Dri