What is Sesamoiditis?

The Sesamoid bones connect to muscles in the foot by tendons. They differ from most bones in the body, which only connect to each other at the joints. Sesamoiditis occurs when the tendons attached to sesamoids inflame and cause pain.

The kneecap is actually the largest sesamoid in the body. Two other much smaller sesamoids sit on the bottom of the foot near the Hallux, or big toe. Sesamoiditis usually refers to the inflammation of the tendons in the foot, not the knee. Physicians usually categorize Inflammation of the tendons attached to the kneecap — patellar tendon and quadriceps tendon — as tendinitis rather than Sesamoiditis.

Sesamoiditis commonly occurs among athletes and dancers. The condition usually stems from straining or overworking the connecting  tendons. Rest and anti-inflammatory medications usually treat Sesamoiditis effectively.

What Causes Sesamoiditis?

Sesamoiditis results from the overuse of the tendons involved with the small bones in the foot. Experiencing repeated trauma to the tendons, such as wearing high heels or poorly fitted shoes can also cause inflammation.

If patients engage in activities that place a lot of pressure on the ball of the foot have a higher risk of developing Sesamoiditis. Patients who partake in Basketball, Running, and ballet commonly develop sesamoiditis.

Symptoms of Sesamoiditis

Sesamoiditis is a condition characterized by inflammation and pain in the sesamoid bones, which are two small bones located beneath the big toe joint. The symptoms of sesamoiditis can vary in severity and may develop gradually over time. Here are some common symptoms associated with sesamoiditis:

Pain: The most common symptom of sesamoiditis is pain in the area of the sesamoid bones, typically located beneath the big toe joint. The pain may be described as a dull ache or a sharp, localized pain. It is often worsened by walking, running, or any activity that puts pressure on the ball of the foot.

Swelling and tenderness: Inflammation of the sesamoid bones can lead to swelling and tenderness in the area. The skin around the sesamoid bones may appear red and feel warm to the touch.

Difficulty bearing weight: The pain and inflammation associated with sesamoiditis can make it difficult to bear weight on the affected foot. Walking or standing may exacerbate the symptoms and cause discomfort.

Limited range of motion: In some cases, sesamoiditis can result in a decrease in the range of motion of the big toe joint. It may become challenging to flex or extend the toe fully.

Pain during toe push-off: Pain may be particularly noticeable during activities that involve pushing off with the toes, such as running or jumping. The push-off motion places increased stress on the sesamoid bones and can trigger pain.

Increased discomfort when wearing certain shoes: Certain types of shoes, particularly those with a narrow toe box or high heels, can worsen the symptoms of sesamoiditis. The pressure exerted on the sesamoid bones by ill-fitting footwear can increase pain and discomfort.

Treatments for Sesamoiditis

Sesamoiditis is a condition characterized by inflammation and pain in the sesamoid bones, which are small bones located beneath the big toe joint. Treatment for sesamoiditis focuses on relieving pain, reducing inflammation, and allowing the affected area to heal. Here are some common treatment options:

Rest and activity modification: Limiting or avoiding activities that exacerbate pain, such as running or jumping, can help reduce stress on the sesamoid bones and promote healing. Resting the foot and modifying activities may be sufficient for mild cases.

Ice therapy: Applying ice packs to the affected area for about 15 to 20 minutes, several times a day, can help reduce pain and inflammation. Be sure to wrap the ice pack in a thin towel to protect the skin.

Pain management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help alleviate pain and reduce inflammation. However, it’s important to consult with a healthcare professional before taking any medication.

Padding and taping: Using padding or adhesive tape around the affected area can help cushion and support the sesamoid bones. This can alleviate pressure and reduce pain during walking or other activities. Your healthcare provider or a podiatrist can guide you on proper taping techniques.

Orthotic devices: Custom-made shoe inserts or orthotic devices can help provide support, redistribute pressure, and improve foot alignment. These devices can offload stress from the sesamoid bones and promote healing.

Footwear modifications: Wearing shoes with a wide toe box and low heels can help reduce pressure on the sesamoid bones. Choosing shoes with good cushioning and arch support can also alleviate discomfort.

Physical therapy: A physical therapist can guide you through exercises and stretches to strengthen the foot muscles, improve flexibility, and correct any biomechanical issues. They may also use modalities like ultrasound or electrical stimulation to aid in pain relief and healing.

Immobilization: In some cases, immobilizing the foot with a cast, walking boot, or stiff-soled shoe can provide rest and protection to the sesamoid bones. Immobilization helps reduce pressure and promote healing.

Steroid injections: In severe cases, where conservative measures have not provided sufficient relief, a healthcare professional may administer corticosteroid injections to reduce pain and inflammation. These injections are typically used sparingly due to potential side effects and limited long-term effectiveness.

Surgery is rarely needed for sesamoiditis and is usually considered only when conservative treatments have failed. Surgical options may include removing the affected sesamoid bone (sesamoidectomy) or repairing any associated damage or abnormalities.

It’s important to consult with a healthcare professional, such as a podiatrist or orthopedic specialist, to determine the most appropriate treatment plan for your specific case of sesamoiditis. They can assess your condition, provide an accurate diagnosis, and recommend the most suitable treatment options to alleviate pain and promote healing.