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Sesamoiditis: Ball of foot Pain


Sesamoiditis: What you need to know


Sesamoid bones are unique to other bones of the body in that they are not connected to other bones via joints. Instead they are connected by tendons or embedded into muscle tissue.

The kneecap and two small bones in the foot are examples of sesamoid bones. They are about the size of a corn kernel. The sesamoid bones of the feet are embedded into the tendons that cause the big toe to move. 

What is sesamoiditis?

The sesamoid bones support your body’s weight. This allows tendons to deliver greater forces on the body, and aid in the lifting of the big toe. 

Sesamoiditis is the inflammation and irritation of these small bones. Ballet dancers, baseball catchers, and runners develop this condition due to the high demand placed on the feet during these activities. Those with a high arch in their feet are also at higher risk of experiencing ball of foot pain due to extra pressure placed on the feet. Adults with osteoarthritis can also experience pain under the big toe due to weakened bones leading to increased inflammation. 

Symptoms of Sesamoiditis

Sesamoid bone fractures can occur with or without sesamoiditis. This makes it challenging at times to decipher between the two conditions. Pain will occur almost immediately following a fracture of a sesamoid bone, but individuals with sesamoiditis will experience pain gradually. 

Other symptoms of sesamoiditis are the following:

  • Bruising 
  • Difficulty bending or straightening the big toe
  • Swelling
  • Pain on the bottom of the foot

Sesamoiditis develops over time. Most patients describe it as a dull pain that comes and goes throughout the day. Pain is usually experienced on the bottom of the foot and toes. The pain caused by sesamoiditis can negatively influence the way a person walks. They may have to shift their weight to the other foot. This reduces the amount of pressure on the bad side.

What’s the best treatment for Sesamoiditis?

Sesamoiditis is a condition characterized by inflammation of the sesamoid bones, small bones located within tendons, typically in the foot. It commonly affects athletes, especially those involved in activities that place repetitive stress on the forefoot, such as running, dancing, or jumping. The goal of treatment for sesamoiditis is to reduce pain, promote healing, and prevent further damage to the sesamoid bones. There are several approaches that can be effective in managing this condition.

  1. Rest and activity modification

Reducing or avoiding activities that exacerbate the pain is crucial in the initial stages of treatment. Rest allows the sesamoid bones to heal and inflammation to subside. Activities that put pressure on the forefoot, such as running or high-impact exercises, should be temporarily avoided.

  • Ice therapy

Applying ice packs or cold compresses to the affected area can help reduce pain and inflammation. Ice should be applied for 15-20 minutes at a time, several times a day, especially after activities or when experiencing pain.

  • Pain management

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can be used to manage pain and reduce inflammation. However, it is important to follow the recommended dosage and consult a healthcare professional if the pain persists or worsens.

  • Footwear modifications

Wearing proper footwear is essential in alleviating pressure on the sesamoid bones. Shoes with a wide toe box, good arch support, and cushioning in the forefoot can help reduce stress on the affected area. In some cases, a podiatrist may recommend using orthotic inserts or custom-made shoe inserts to provide additional support.

  • Padding and taping

Padding or taping the affected area can help relieve pressure and distribute the load more evenly. This can be done using adhesive felt pads, which are placed over the sesamoid bones to cushion and protect them during activities.