Understanding Sesamoiditis: Causes, Symptoms, and Treatment Options

If you’ve ever experienced pain in the ball of your foot—especially beneath your big toe—you might be dealing with a condition known as Sesamoiditis. Though it’s not as commonly discussed as plantar fasciitis or bunions, sesamoiditis is a painful and often frustrating foot ailment that can significantly affect mobility. Let's dive into what it is, why it happens, and how it can be managed.

What is Sesamoiditis?

Sesamoiditis is the inflammation of the sesamoid bones—two small, pea-shaped bones embedded within the tendons beneath the big toe joint. These bones help the tendons move smoothly and act like pulleys to improve the efficiency of the toe joint.

When these bones or the tendons surrounding them become irritated or inflamed due to overuse, trauma, or stress, it results in sesamoiditis. This condition is most commonly seen in athletes, dancers, and individuals who spend a lot of time on their feet.

Common Causes

There are several triggers for sesamoiditis, including:

• Repetitive stress or overuse, especially from activities like running, basketball, or ballet

• Wearing high heels or shoes with insufficient cushioning

• Sudden increase in activity level

• Foot structure abnormalities (e.g., high arches or a prominent first metatarsal head)

• Direct trauma, such as a fall or impact to the ball of the foot

Symptoms to Watch For

People with sesamoiditis typically report:

• Pain beneath the big toe, especially on the ball of the foot

• Swelling or bruising around the joint

• Difficulty bending or straightening the big toe

• Aching or sharp pain that worsens with activity and improves with rest

• Tenderness when pressing on the area beneath the big toe

If left untreated, chronic inflammation can lead to further complications, including fractures or degeneration of the sesamoid bones.

Diagnosis

A proper diagnosis usually involves:

• Physical examination by a podiatrist or orthopedic specialist

• X-rays, to rule out fractures or arthritis

• MRI or bone scans, if soft tissue damage is suspected

Early diagnosis is key to preventing long-term problems.

Treatment Options

Treatment for sesamoiditis often starts with conservative methods:

1. Rest and Activity Modification

• Reduce weight-bearing activities to allow inflammation to subside.

2. Footwear Changes

• Switch to shoes with cushioned soles, a wide toe box, and low heels.

3. Orthotics

• Custom inserts can redistribute pressure away from the sesamoid bones.

4. Ice and Anti-inflammatory Medications

• Ice the area several times a day and consider NSAIDs (like ibuprofen) for pain relief.

5. Taping or Padding

• Special pads (metatarsal pads or dancer’s pads) can offload pressure from the sesamoids.

If conservative treatments fail after several weeks or months, more advanced interventions might be considered:

• Corticosteroid injections (used sparingly to avoid weakening surrounding tissues)

• Physical therapy to improve foot biomechanics

• Surgery (in rare, severe cases) to remove a damaged sesamoid bone

Preventing Sesamoiditis

While not all causes of sesamoiditis can be prevented, you can reduce your risk by:

• Wearing supportive footwear, especially during exercise

• Avoiding excessive impact on hard surfaces

• Gradually increasing activity intensity

• Using orthotic support if you have flat feet or high arches

Final Thoughts

Sesamoiditis can be a nagging, painful condition, but with proper care and early intervention, most people recover fully without the need for surgery. If you suspect you’re experiencing symptoms, schedule an appointment with Dr. Gireesh Reddy or Dr. Sirisha Pokala at Restore Foot & Ankle Specialists by calling (469) 573-3427 or by booking an appointment online.

Remember: Your feet carry you through life—take good care of them!