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Sesamoiditis

Sesamoid bones near the great toe

Sesamoiditis is inflammation of the sesamoid bone and surrounding tissue.  Sesamiods are small bones embedded in tendons of the great toe. They are surrounded by tendons. Like other bones, they can break and the tendons around them can become inflamed.   It is usually caused by bending the big toe upward.  There may be a break in the bone, or just irritation in the joint between the sesamoid and the 1st metatarsal.  Due to the low vasculation (low blood supply) of the area, sesamoiditis can take a long time to heal on its own.  Due to constant pressure to this area during healing (from walking), it can progress to a chronic condition called Sick Sesamoid Syndrome, where the symptoms don't improve.  Some of the symptoms are pain in the big toe or ball of foot, difficulty bending or moving the big toe, or bruising around the big toe.  

Treatment:

Surgery is usually not required to treat sesamoiditis, but is available as a last resort.  If it progresses to Sick Sesamoid Syndrome, surgery may be required.  Some cases can be resolved with rest, ice and anti-inflammatory medications.  Sometimes special padding or an orthotic device is prescribed to move pressure away from the affected area.  Steroids can be prescribed for inflammation, but steroids are not the best option if a stress fracture may be present. Avoiding heels and wearing shock absorbing shoes can help relieve pain and promote healing. 

 

Brandt R Gibson, DPM
Podiatrist, Neuropathy Doctor, Father of 11 and Founder of Mountain West Foot & Ankle Institute