Sesamoiditis

Sesamoiditis is a form of tendonitis. Sesamoids are small bones that are not connected at a joint to other bones. Instead, a sesamoid acts with a tendon. It provides a surface for the tendon and acts like a pulley. There are two sesamoids located in the foot. The sesamoids are located near the underside of the big toe. They support the bones of the big toe, help absorb impact, and help with weight-bearing pressure.

Sesamoiditis occurs when the tendon and tissue around the sesamoid becomes inflamed and irritated. Activities that repeatedly place excessive pressure on the ball of the foot can lead to sesamoiditis. Athletes, especially baseball catchers and ballet dancers, are at risk for this condition. Sesamoiditis may cause pain or swelling. Pain may gradually worsen. The pain is usually felt under the big toe and in the ball of the foot.

The doctor will examine and manipulate the foot to determine the origin of the pain. The doctor is likely to question the patient about the onset of the symptoms. Pain from sesamoiditis has a gradual onset. If the sesamoid was fractured or broken, the pain was likely to occur immediately after the injury. An x-ray or bone scan is often used to determine if the sesamoid is broken or fractured. The doctor may tape the big toe in the position of being bent slightly bent downward. Shoes worn during recovery should be soft-soled with a low heel. Shoe pads may be recommended by the physician.

The doctor may suggest resting and applying ice packs to the foot. Pain relievers, such as over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended. If swelling is problematic, the doctor may administer a local steroid injection. If these treatments do not alleviate the symptoms, the doctor may prescribe the use of a leg brace or below-the-knee walking cast.