Sesamoiditis Symptoms & Treatment

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What Is Sesamoiditis?

Sesamoiditis causes pain at the ball of the foot, beneath the big toe joint. The sesamoid bones are embedded in a tendon, similar to the kneecap, and they help increase the leverage of the tendons that control the big toe. Because of their location and function, the sesamoid bones experience significant pressure and forces every time the big toe is used to push the foot forward.
diagram explaining and displaying where the pain from sesamoiditis would be caused, while containing text explaining how it is caused

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What Causes Sesamoiditis?

Sesamoiditis occurs when the sesamoid bones, two small bones located beneath the big toe joint, become irritated or injured due to overuse and repetitive impact.

Symptoms Of Sesamoiditis

The symptoms of sesamoiditis typically worsen gradually. What begins as a mild ache can quickly progress to intense throbbing. As the condition becomes more severe, it may become difficult to put weight on the big toe or walk comfortably. You might also notice swelling or redness around the big toe joint, along with pain when attempting to bend the toe upwards.

Injuries to the sesamoid bones can vary from mild irritation to a fracture. It’s important to seek early treatment to prevent the condition and pain from worsening.

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Who Suffers From Sesamoiditis?

While anyone can develop sesamoiditis, those who engage in activities that involve repetitive loading of the ball of the foot, such as dancing, sprinting, or even walking, are more likely to experience this condition. Individuals with prominent foot bones, higher arched feet, flat feet, or those who tend to run on the ball of their foot are also more prone to developing sesamoiditis.

Sesamoiditis Treatment

Treatment for sesamoiditis is tailored to the individual and their symptoms, typically starting with relieving pain and reducing pressure on the sesamoid bones. This can be achieved through padding, strapping, or custom orthotics, along with the use of ice, oral anti-inflammatories, and temporarily stopping the activity causing the pain.
 
The next step is to heal the damaged bones and surrounding tissues while addressing any contributing factors to prevent the condition from recurring. A common approach involves using full-length custom orthotics combined with supportive footwear. The orthotics are designed to redirect pressure away from the big toe joint, redistributing it across the lesser toes at the ball of the foot. They can also address contributing issues such as flat feet, high arches, bunions, or reduced plantar fat padding.
 
In cases of persistent or severe sesamoiditis, or stress fractures of the sesamoids, a short leg pneumatic walker with a rocker sole (walking cast) for 2 to 6 weeks may be needed. If this doesn’t help, steroid injections or surgery may be considered.

 

Sesamoiditis Surgery
In severe cases or after a true sesamoid fracture, surgery may be necessary to remove the damaged or fragmented sesamoid bone. Due to reduced blood supply in some cases, healing may be delayed or absent, requiring a surgical review.

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