Sesamoiditis

Sesamoiditis is an injury of the sesamoid bones, the two small bones under the foot near the big toe. Instead of being connected to other bones in the foot, the sesamoid bones are embedded in tendons. Sesamoiditis occurs when the bones and tendons become inflamed from overuse.

Causes

Overuse is the primary cause of sesamoiditis. The condition is common in athletes and dancers who routinely transfer weight to the ball of the foot. People who wear high heel shoes or who have flat feet can also experience sesamoiditis.

Symptoms

Symptoms of sesamoiditis are usually a dull pain or ache under the big toe and ball of the foot. Swelling, redness, and bruising are also common. As symptoms increase with time, it can be difficult to walk or move the big toe.

Diagnosis

In order to diagnose sesamoiditis, physicians will ask about symptoms and examine the foot. Some factors physicians will look for include tenderness at the ball of the foot and difficulty walking or moving the big toe. A technique called the Passion Axial Compression test is sometimes used to manipulate the joint to reproduce symptoms of sesamoiditis. Imaging tests may also be required to rule out other factors, such as stress fractures.

Treatment

Treatment for most sesamoiditis cases includes rest, ice, anti-inflammatory medications, corticosteroid injections, and taping the big toe. Physical therapy and leg braces are also effective. In rare cases where sesamoiditis is chronic and debilitating, surgery may be required to remove one of the sesamoid bones.