Sesamoiditis

What is Sesamoiditis?

If you are experiencing foot pain under your big toe, you may be suffering from sesamoiditis.

Most bones in the human body connect at the joints. However, a few, such as the kneecap (patella) and two smaller bones (the size of peas!) in the underside of your foot, are different.

Instead, these bones connect to tendons or are embedded in muscle, which act like pulleys. One of these small bones is near your big toe, one is on the outer side of the foot and the final one is closer to the middle of the foot.

These bones are called sesamoids and help with both weight-bearing and elevating the bones in your toe.

As with the other bones in your body, sesamoids can break or become irritated, painful and/or inflamed. The pain can also become intensified when you walk — especially in high heels or shoes that have no support in the sole.

Sesamoiditis can be a common condition in runners and dancers.

You may be suffering from sesamoiditis if you: 
  • Feel pain that worsens when you walk
  • Feel pain when you wear thin-soled or high-heeled shoes
  • Experience inflamed feet
  • Experience swelling or redness (this may extend to the outside of your feet and affect the big toe joint)
Clinical diagnosis: This is the most commonly used method in specialist pain clinics and is based on the experience and knowledge of the Podiatrist. However, this is only the first stage of your assessment and we don’t simply rely of informed guesswork.

Diagnostic Ultrasound: Your podiatrist will perform a diagnostic ultrasound to differentiate between soft tissue and bone. The scan is a safe and effective way to identify soft tissue and, therefore, rule out a fracture. The scan will display the surface of the bone, which will guide your podiatrist to make a more accurate clinical diagnosis and lead to a more accurate approach to your care
At Footfocus Podiatry, your care is always our top priority, and so we also use diagnostic ultrasound in suspected cases of sesamoiditis for guidance on treatment such as Shockwave therapy, steroid injection and local anaesthetic use. We use this state of the art tool to provide a targeted treatment that minimises discomfort and pain. 
 
Pressure plate analysis: We have a high tech force pressure plate which has 4000 sessors and shows us and you where the pressure is going when you walk. This is invaluable to ensuring the right orthotic prescription is used at the right time. 
Generally, careful strapping and advice on appropriate footwear and orthotics are sufficient to treat the acute stage of sesamoiditis. We can utilise everything in our clinic such as gait re-education, shockwave therapy and custom orthotics to help prevent this problem returning.
 
Another course of action your podiatrist may take to reduce your symptoms of inflammation is a corticosteroid/anaesthetic solution.
 
In some circumstances, a diagnostic ultrasound of your other foot will be required for comparison. We want to ensure you receive the best possible treatment to prevent future foot pain and concerns, and so in some cases. Our podiatrist may refer you for surgical opinion where necessary.