Sesamoiditis is a painful inflammation that causes pain in the ball of the foot, usually near the big toe. Pain from sesamoiditis can be a mild ache or intense throbbing, and is often aggravated by movement of the big toe joint. Sesamoiditis usually has a gradual onset. There may be swelling, which can cause reduced movement of the big toe and difficulty walking.

The sesamoid bones are tiny bones within the tendons that run to the big toe. These bones help to absorb impact forces in the forefoot, and help with bending of the big toe when walking.

What causes sesamoiditis?

Any activity that puts increased force on the ball of the foot can cause sesamoiditis. For example, dancers and people with high-arched feet can be prone to developing this condition. Damage to the sesamoid bones (such as a fracture) can also lead to sesamoiditis.

How is sesamoiditis treated?

Sesamoid problems generally do not heal on their own, but fortunately noninvasive treatment is usually effective.

The focus of treatment for cases of sesamoiditis is to reduce pressure on the sesamoid bones. Treatment can include:

  • A strict period of rest
  • Use of a modified shoe or a shoe pad with a cutout to reduce pressure on the affected area
  • Strapping to help immobilise the big toe joint
  • Ice and anti-inflammatory medication may be recommended to reduce swelling
  • Custom orthotics may also be recommended to reduce pressure on the sesamoid area

More severe cases of sesamoiditis can require a walking cast and a steroid injection.

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