Sesamoiditis is a general term describing irritation or inflammation of the tendons surrounding the sesamoid bones (the two small bones within the tendons that run to the big toe). This condition causes sharp pain in the ball of the foot, directly beneath the big toe joint.

Sesamoiditis is common among active individuals, particularly runners and ballet dancers. Treatment is generally nonsurgical; in most cases, pain can be reduced by resting the feet and relieving pressure on the sesamoid bones.

Causes of sesamoiditis

Sesamoiditis is basically an overuse injury. The sesamoid bones are located directly beneath a weight-bearing area of the foot, which means that every time you push off from the ground the sesamoids and surrounding tendons are involved. This constant pressure on the tendons eventually takes its toll, causing inflammation and discomfort.

Sesamoiditis usually occurs following an increase in any type of activity that puts excessive pressure on the foot, including running and jumping. People with high arches naturally put more pressure on the balls of their feet and are consequently at an increased risk of developing sesamoiditis. The condition is also common in people with bony feet who have thinner fat pads protecting the tendons surrounding the sesamoid bones.

Sesamoiditis symptoms

The primary symptom of sesamoiditis is pain beneath the big toe on the ball of your foot. The pain can be mild and intermittent, brought on by walking, or it can be more severe and persistent, making it difficult to flex your toe or put pressure on the ball of your foot.

The pain may also be accompanied by swelling, bruising, and discoloration. Walking in bare feet and wearing thin-soled shoes can further irritate the tendons surrounding the sesamoids.

Treatment of sesamoiditis

The first step in treating sesamoiditis is to reduce pressure on the ball of your foot. This can be achieved by modifying activity, switching to comfortable shoes, and icing the toe joint.

If these steps fail to relieve the pain associated with sesamoiditis, further treatment may include:

• Cortisone injections.
• Custom orthotic shoe inserts.
• Immobilizing the joint with tape or a foot brace.
• Physical therapy and stretching.

In rare cases, surgery may be necessary.

Treatment of sesamoiditis will depend on the extent of damage to the tendons; it is best to see your doctor for proper diagnosis and treatment recommendations.