Did you know that the term “sesamoid” comes from the Greek word for “sesame seed”, reflecting the size of these bones? Despite their tiny appearance, sesamoids play a crucial role in supporting the mechanics of your foot. Positioned beneath the big toe joint, they help absorb impact and reduce friction during movement. However, when these bones are subjected to repeated stress or overuse, they can become inflamed, leading to a painful condition known as sesamoiditis.
The inflammation usually begins with a dull ache or mild pain in the ball of the foot. Over time, this discomfort can worsen, gradually making simple activities like walking or standing more challenging. If left unattended to, the pain might become more intense, eventually limiting mobility and affecting your daily routine. To manage this condition, it’s crucial to first understand the underlying factors. Now, let’s explore the causes of sesamoiditis and how they contribute to this discomfort.
Causes of Sesamoiditis
Sesamoiditis is primarily caused by repetitive stress on the tendons surrounding the sesamoid bones, which are located beneath the big toe joint. This stress builds up over time, particularly in activities that place significant pressure on the ball of the foot. Running and jumping are common contributors, as these actions frequently push weight onto the forefoot.
Sports like football further intensify this risk due to the sudden pivots, sprints, and directional changes that place additional stress on the ball of the foot. The constant movement and quick shifts concentrate pressure on the sesamoid bones, increasing the chances of inflammation. For runners, the likelihood of developing sesamoiditis is particularly high if they overpronate. Overpronation is when the foot rolls inward excessively during movement. This results in further strain to the sesamoids, amplifying the risk of inflammation.
Other athletes, as well as dancers who frequently push off from the forefoot, experience similar repetitive strain, contributing to the development of sesamoiditis. This constant pressure on the forefoot creates a cumulative effect over time, leading to the painful symptoms associated with the condition.
Beyond physical activity, footwear plays a significant role. People who regularly wear high heels or shoes with inadequate support, as well as those with structural foot variations such as high arches or flat feet, are more prone to this condition. These factors increase pressure on the sesamoids, making inflammation more likely. Weight gain can also exacerbate this problem by adding extra stress on the forefoot.
Rarely, sesamoiditis can also be a side effect of gout. Conversely, an injury or inflammatory cause, like sesamoiditis, might trigger a gout attack. This dual relationship underscores the broader complexity of sesamoiditis and its interaction with other foot conditions.
Symptoms of Sesamoiditis
Sesamoiditis develops gradually, often starting with mild discomfort under the big toe that worsens over time. As the condition progresses, various symptoms can affect daily activities, making walking and standing more difficult. The symptoms of sesamoiditis typically include:
- Pain under the big toe: A persistent ache that begins as mild discomfort but becomes sharper with continued pressure and activity.
- Pain when weight-bearing: Pain worsens when pressure is placed on the affected foot, making it difficult to stand or shift weight comfortably.
- Pain when walking: Simple movements like walking can trigger more intense pain, especially during prolonged periods of activity.
- Difficulty bending the big toe: Inflammation limits flexibility, making it difficult to bend or flex the big toe without pain.
- Swelling: Visible swelling may occur around the big toe joint as inflammation increases, making the area more sensitive.
- Redness: The affected area often becomes red due to ongoing irritation and inflammation around the sesamoid bones.
- Bruising: While less common, bruising can appear if there is additional trauma to the area alongside the inflammation.
Conditions Commonly Mistaken for Sesamoiditis
Several foot conditions share symptoms with sesamoiditis, such as pain and swelling, and may be mistaken for it. Here are some common ones:
- Bursitis: Inflammation of the bursa, a fluid-filled sac that cushions joints, can mimic sesamoiditis symptoms such as pain and swelling beneath the big toe joint. However, bursitis primarily affects the soft tissue around the joint, not the sesamoid bones themselves.
- Bunions: Bunions are bony bumps at the base of the big toe that cause pain, swelling, and redness. Unlike sesamoiditis, which stems from inflammation of the sesamoid bones due to stress or overuse, bunions are the result of joint misalignment and develop gradually over time.
- Ganglion Cyst: A ganglion cyst is a fluid-filled lump that can form near joints or tendons, often causing discomfort due to its location. In contrast, sesamoiditis involves inflammation and pain in the sesamoid bones beneath the big toe joint, typically caused by repetitive stress rather than a soft tissue lump.
- Gout: Gout is an inflammatory arthritis that frequently targets the big toe joint, causing sudden, severe pain, redness, and swelling. Unlike sesamoiditis, which develops gradually from overuse of the sesamoid bones, gout flares are triggered by metabolic factors and occur intermittently.
- Hallux Rigidus (Osteoarthritis): Hallux rigidus is a form of osteoarthritis in the big toe joint, resulting in stiffness, pain, and limited movement. It differs from sesamoiditis, which causes localised pain beneath the joint due to inflammation of the sesamoid bones rather than joint degeneration.
- Rheumatoid Arthritis: This autoimmune condition can affect multiple joints, including the big toe. While rheumatoid arthritis causes swelling, pain, and deformities, sesamoiditis is more localised, with pain and inflammation centred beneath the big toe joint without the systemic symptoms like fatigue and stiffness.
Managing and Preventing Sesamoiditis
Sesamoiditis can be addressed through various methods, though not all options offer lasting solutions. While some approaches might alleviate discomfort, others aim to support the body’s natural recovery process and help prevent future flare-ups.
Managing Pain and Inflammation
Medications like Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are commonly used to manage pain and inflammation. However, due to potential side effects from prolonged use, NSAIDs are often considered a temporary measure. Corticosteroid injections might also be recommended to reduce inflammation, but they are generally used only in specific cases where immediate pain relief is needed.
Encouraging Recovery with Non-Invasive Therapies
For longer-term management, non-invasive therapies such as Extracorporeal Shockwave Therapy (ESWT) and the Super Inductive System (SIS) can play a significant role. ESWT, by delivering focused energy to the affected area, may help stimulate tissue repair and reduce discomfort, offering a solution that addresses the root of the issue rather than just the symptoms. Through the use of pulsed electromagnetic fields, SIS helps promote cellular regeneration and reduce inflammation. These therapies are increasingly explored as part of a broader approach to managing sesamoiditis, with the aim of supporting the body’s natural healing processes and reducing the reliance on invasive interventions.
Surgery as A Last Resort
Surgery is generally viewed as a last resort and is only considered when non-invasive options have not been effective in providing sufficient relief. The procedure may involve removing a sesamoid bone or both to alleviate ongoing discomfort. However, it is typically reserved for severe cases due to the risks and recovery time involved.
Rest and Reducing Pressure
When managing sesamoiditis, it’s essential to prioritise rest. Begin by limiting any activities that place pressure on the ball of your foot, as this will allow inflammation to decrease over time. Elevate your foot to help reduce swelling and use ice intermittently to soothe discomfort and keep inflammation under control. For added support, consider using sports taping or a brace around the big toe to limit movement and provide extra stability. These small adjustments can make a significant difference in reducing strain on the sesamoid bones and promoting natural recovery.
Preventive Measures
Once your symptoms have subsided, customised in-shoe orthotics can be a valuable tool for preventing future flare-ups. Orthotics are designed to redistribute weight evenly across the foot, which helps relieve pressure on the sesamoid bones, reducing the chances of irritation. They are particularly effective for individuals with high arches, flat feet, or those who regularly engage in activities that place stress on the forefoot. By using orthotics, you can provide ongoing support and reduce the risk of the condition recurring, allowing you to remain active while protecting your feet.
Get Relief from Sesamoiditis at East Coast Podiatry
If you’re experiencing persistent pain in the ball of your foot, addressing it promptly can help prevent sesamoiditis from worsening. At East Coast Podiatry, we begin by thoroughly evaluating your condition, using advanced tools like ultrasound imaging to accurately assess the extent of the strain on your sesamoid bones. Understanding the severity and underlying causes of the condition is crucial, as it allows us to tailor a plan that focuses on immediate pain relief and long-term management.
Once we have a clear understanding of your condition, we can then explore non-invasive options like ESWT and SIS. These therapies are often recommended to manage discomfort and address the factors contributing to sesamoiditis. To further support your recovery, custom orthotics may be introduced. By redistributing pressure away from the sesamoid bones, orthotics help reduce strain and protect these small yet vital bones during movement. This combined approach focuses on immediate pain relief and long-term foot health, helping you stay active and pain-free. If you’re ready to take the next step toward lasting relief, contact us today to schedule an appointment, and let our experienced podiatrists create a personalised plan for you.
Frequently Asked Questions About Sesamoiditis
Sesamoiditis is an inflammation of the sesamoid bones, small bones located under the big toe, which play a key role in movement and weight-bearing. This condition often arises from increased pressure on the sesamoid bones due to factors such as sudden changes in activity, repetitive movements from sports, or trauma. Wearing unsupportive footwear, like sandals or high heels, can also contribute by straining the ball of the foot. Other contributing factors include foot structure, such as having high arches or flat feet, large sesamoid bones, and conditions like osteoarthritis. Managing these factors early can help prevent the condition from worsening.
If you’re wondering whether your pain is due to sesamoiditis, there are some key signs to look out for. One of the most common symptoms is pain beneath the big toe, especially when walking or bending the toe. This pain tends to worsen with weight-bearing activities, such as walking or running, but often eases when you’re off your feet. You might also experience pain when pressing directly on the affected area, along with possible swelling around the big toe joint. If you’re noticing these patterns, it could indicate sesamoiditis, and it’s best to seek professional evaluation.
Both sesamoiditis and gout can cause pain in the big toe, but there are key differences. Gout typically presents with sudden, intense pain, often accompanied by redness and swelling, and is triggered by a buildup of uric acid in the joint. On the other hand, sesamoiditis develops gradually due to repetitive stress or overuse of the sesamoid bones beneath the big toe. With sesamoiditis, the pain often worsens with activity like walking or weight-bearing and improves with rest, whereas gout usually causes sharp flare-ups that can come on quickly and intensely.
A podiatrist can help manage sesamoiditis by recommending rest, ice application, and modifying activities to reduce stress on the sesamoid bones. They may also prescribe custom orthotics to redistribute pressure and provide better foot support. In some cases, shockwave or pulsed electromagnetic field therapy will be suggested to promote healing and alleviate discomfort. Additionally, they might use sports taping or bracing to limit toe movement, protecting the sesamoid bones and aiding recovery.
Yes, sports taping can be beneficial for managing sesamoiditis. It helps by improving the alignment and function of the forefoot, which reduces strain on the sesamoid bones. One of the key benefits of taping is that it limits the shear forces, or sideways pressure, that occurs when the foot moves and the bones rub against the soft tissues. These forces can irritate the sesamoid bones and increase pain. By stabilising the big toe joint, taping helps decrease this friction, allowing the foot to move more comfortably while protecting the sesamoid area from further irritation.
