Sesamoiditis: Symptoms, Causes, Tests, and Treatments

Did you know that there are bones that don't connect to any other bone? These bones are called sesamoids, and they're only attached to tendons or embedded in muscle. They protect tendons from wear and improve muscle force generation. Two tiny sesamoids are located near the big toe on the bottom of the forefoot, functioning like pulleys for the tendons.

Sesamoiditis is a type of tendonitis that develops in the ball of the foot under the big toe, causing inflammation and pain. Runners, dancers, and athletes who constantly bear weight on the balls of their feet are more prone to this condition. Here is all the information you need to understand sesamoiditis.

Symptoms

Symptoms of Sesamoiditis can include

• Pain under the big toe on the ball of the foot, worsening when bearing weight and improving at rest or when elevated
• Difficulty bearing weight or walking on the affected foot
• Swelling, redness, or bruising on the affected foot
• Difficulty bending and straightening the big toe

Causes

Possible causes of sesamoiditis include:

• Overuse: Overusing the tendons that connect to the foot's sesamoid bones; this is commonly seen in those who wear high heels, athletes, and dancers
• Ill-fitting shoes: Wearing shoes that are too small, tight, or with hard insoles can cause pain and inflammation

Test for Sesamoiditis

To diagnose sesamoiditis, your healthcare practitioner will begin with a thorough examination of your foot, possibly using the Passive Axial Compression test to mimic sesamoiditis symptoms. During the examination, the doctor or physiotherapist will look for tenderness at the site of the sesamoid bones by asking you to bend and straighten the big toe. They may also bend the toe toward the top of the foot to see if the pain intensifies. This hands-on assessment helps them determine the extent of the inflammation and pinpoint the exact location of the pain.

In some cases, if a stress fracture is suspected, your healthcare practitioner may recommend further imaging tests, such as a bone scan or a CT scan. These scans can provide a more detailed view of the bones and help to identify any fractures or other abnormalities that could be contributing to your symptoms. By combining the results of the physical examination with the imaging tests, your healthcare provider can determine the most accurate diagnosis and recommend an appropriate treatment plan for your sesamoiditis.

Treatments

Potential treatment methods include:

• Stopping the activity that causes pain
• Taking over-the-counter anti-inflammatory medications
• Resting and icing the sole of your feet
• Taping the big toe so that it remains bent downward
• Wearing soft-soled shoes
• Using insoles or custom orthotics
• Physiotherapy

Conclusion

Preventative care is key to avoiding sesamoiditis. Wear comfortable shoes, use custom orthotics, and follow rest, ice, and elevation after strenuous exercises. Pay attention to discomfort cues and see a doctor if the pain persists. Taking control of your foot health will aid in a swift recovery.