Sesamoiditis

Definition: Sesamoiditis is an inflammatory condition affecting the sesamoid bones, two small, pea-shaped bones located in the ball of the foot beneath the big toe. These bones assist with weight-bearing and act as a pulley for tendons.

Causes:

• Overuse from activities that put excessive pressure on the ball of the foot, such as running, dancing, or high-impact sports
• Wearing high-heeled shoes or footwear with insufficient support
• Anatomical abnormalities, such as high arches or flat feet
• Sudden increases in physical activity

Symptoms:

• Pain and tenderness in the ball of the foot, particularly beneath the big toe
• Swelling and inflammation in the affected area
• Difficulty and pain when walking, especially during push-off phase
• Pain that worsens with activity and improves with rest

Diagnosis:

• Physical Examination: Assessing pain, swelling, and tenderness in the ball of the foot.
• Imaging Tests: X-rays to rule out fractures; MRI or ultrasound may be used to detect inflammation or soft tissue damage.

Treatment:

• Rest: Reducing or avoiding activities that exacerbate the pain.
• Ice: Applying ice packs to reduce swelling and pain.
• Footwear Changes: Switching to shoes with proper support and cushioning; avoiding high heels.
• Orthotic Devices: Using custom insoles or pads to relieve pressure on the sesamoid bones.
• Medications: Anti-inflammatory drugs to manage pain and reduce inflammation.
• Physical Therapy: Exercises to strengthen and stretch the muscles and tendons of the foot.
• Injections: Corticosteroid injections may be used for severe inflammation.
• Surgery: Rarely needed, but in chronic or severe cases, surgery may be considered to remove part or all of the sesamoid bone.

Prognosis: With proper treatment, most individuals with sesamoiditis can achieve significant pain relief and return to their normal activities. Early intervention and modifying activities that put pressure on the sesamoid bones are crucial to preventing chronic issues. Regular use of supportive footwear and adherence to recommended treatments can help manage and prevent recurrences.