Sesamoiditis vs Bunion Pain: Why It Matters to Know the Difference

When it comes to pain at the ball of your foot or near your big toe, two conditions often come to mind: sesamoiditis and bunions. While they may seem similar at first, understanding the difference can make a world of difference—especially when it comes to walking comfortably, staying active, and preventing long-term foot complications.

At East Coast Podiatry in Singapore, we frequently see patients who confuse one for the other. And that’s completely understandable—both conditions involve the area around the big toe joint, but their causes, progression, and management options vary widely.

Let’s break it down.

What is Sesamoiditis?

Sesamoiditis refers to inflammation or irritation of the sesamoid bones—two small pea-shaped bones located beneath the big toe joint. These bones help absorb weight-bearing pressure and act like pulleys to aid movement of the big toe.

Common signs of sesamoiditis include:

• A dull, aching pain under the ball of the foot
• Pain that worsens with movement or impact (e.g. running, dancing, jumping)
• Swelling or bruising under the big toe joint
• Difficulty bending or pushing off with the toe

It’s more common in athletes, dancers, runners, and individuals who wear high heels or thin-soled shoes. Poor foot biomechanics and flat feet can also contribute.

What is a Bunion?

A bunion, or hallux valgus, is a bony bump that forms at the base of the big toe. This condition occurs gradually as the big toe shifts inward, pressing against the second toe and causing the joint to protrude outward.

Key symptoms of bunions include:

• Visible bump on the side of the foot at the big toe joint
• Pain or redness at the bump, especially when wearing tight shoes
• Stiffness or reduced range of motion in the big toe
• Progressive misalignment over time

Bunions tend to be more structural and progressive. They can run in families, but are also influenced by footwear choices, hypermobility, and existing foot shape (such as flat feet or high arches).

Where the Confusion Happens

Because both conditions affect the big toe region and can involve pain when walking, it’s not always easy to tell which one you’re dealing with—especially in the early stages.

That’s where a podiatrist in Singapore comes in. At East Coast Podiatry, we conduct a detailed review, gait assessment, and imaging when necessary to confirm the cause. Getting it right early matters: sesamoiditis can improve significantly with offloading and footwear changes, while bunions tend to worsen without early intervention.

Why Early Attention is Crucial

Ignoring the pain or self-managing for too long may worsen the condition. For sesamoiditis, continued stress can lead to stress fractures or chronic inflammation. For bunions, ongoing pressure from misalignment can eventually affect the second toe, leading to further issues like hammertoes or corns.

Whether you’re a runner struggling with sesamoid pain or someone whose shoes no longer fit right due to a growing bunion, a personalised care plan from a podiatry practice in Singapore can make a tangible difference.

What We Do at East Coast Podiatry

• Gait analysis to assess walking patterns and foot structure
• Footwear and pressure assessment to identify aggravating factors
• Custom orthotics to reduce load on the sesamoids or correct misalignment
• Shockwave therapy (for sesamoiditis) to address chronic inflammation
• Conservative bunion care including offloading and strength-building
• Monitoring and support to delay progression and reduce discomfort

Our podiatrists work closely with each patient to address not just the symptoms but the biomechanical root cause, whether that’s in the joint, the gait, or the footwear.

When in Doubt, Get Your Foot Pain Reviewed

If you’re experiencing big toe pain and aren’t sure whether it’s a bunion, sesamoiditis, or something else entirely, we encourage you to have it checked early. At East Coast Podiatry, our goal is to support active lifestyles, prevent worsening conditions, and help you walk pain-free.

Book a consultation at one of our podiatry practices in Singapore today.