Sesamoiditis is a condition that causes pain and inflammation in the sesamoid bones, two small bones located beneath the big toe joint. These bones are embedded within the tendons and act as a pulley to help the tendons move smoothly. Sesamoiditis can significantly affect your mobility and quality of life. This article will explore the causes, symptoms, and treatment options for managing sesamoiditis.

What is Sesamoiditis?

Sesamoiditis is an inflammation of the sesamoid bones and the surrounding tendons in the forefoot. Unlike most bones in the body, sesamoids are not connected to other bones via joints. Instead, they are embedded in tendons and are crucial for bearing weight and enabling smooth movement.

Causes of Sesamoiditis

Several factors can contribute to the development of sesamoiditis, including:

- Overuse: High-impact activities such as running, dancing, or jumping can strain the sesamoid bones and surrounding tendons.

- Foot Mechanics: High arches, flat feet, or abnormal gait patterns can place extra stress on the sesamoids.

- Footwear: Wearing high heels or shoes with inadequate support can exacerbate the condition.

- Trauma: Direct injury to the forefoot, such as a fall or impact, can cause sesamoiditis.

- Arthritis: Inflammatory conditions like rheumatoid arthritis can affect the sesamoid bones.

Symptoms of Sesamoiditis

Identifying sesamoiditis involves recognizing several key symptoms:

- Pain: Aching pain beneath the big toe that worsens with activity and improves with rest.

- Swelling: Swelling and tenderness in the ball of the foot.

- Difficulty Moving: Pain when bending or straightening the big toe.

- Bruising: In some cases, bruising may occur in the affected area.

Diagnosis of Sesamoiditis

At Bondi Podiatry, diagnosing sesamoiditis involves a thorough physical examination and, if necessary, imaging tests such as X-rays or MRI to confirm the condition and rule out other potential causes of foot pain.

Management and Treatment Options

Effective management of sesamoiditis involves a combination of conservative and, in severe cases, surgical treatments. Here are the main treatment options:

Conservative Treatments

1. Rest and Activity Modification

- Rest: Reducing or avoiding activities that exacerbate the pain can allow the sesamoid bones to heal.

- Activity Modification: Switching to low-impact activities, such as swimming or cycling, to reduce strain on the forefoot.

2. Ice Therapy

- Ice Packs: Applying ice packs to the affected area for 15-20 minutes several times a day can reduce inflammation and pain.

3. Footwear Modifications

- Supportive Shoes: Wearing shoes with good arch support and cushioning to alleviate pressure on the sesamoid bones.

- Avoiding High Heels: Opting for flat shoes to reduce stress on the forefoot.

4. Orthotic Devices

- Custom Orthotics: Custom-made orthotic inserts can provide additional support and redistribute pressure away from the sesamoid bones.

- Metatarsal Pads: Placing pads beneath the ball of the foot to reduce stress on the sesamoids.

5. Taping and Padding

- Taping: Taping the big toe can help stabilize the joint and reduce strain on the sesamoid bones.

- Padding: Using pads to cushion the ball of the foot and relieve pressure.

6. Physical Therapy

- Stretching and Strengthening Exercises: Exercises to improve flexibility and strengthen the muscles surrounding the sesamoid bones.

- Massage Therapy: Gentle massage to reduce muscle tension and improve circulation.

7. Medications

- NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain and reduce inflammation.

Advanced Treatments

1. Corticosteroid Injections

- Cortisone Injections: Administering corticosteroid injections to reduce severe inflammation and pain. This treatment is typically reserved for cases where conservative methods have not provided sufficient relief.

2. Shockwave Therapy

- Shockwave Therapy: Using sound waves to stimulate healing in the sesamoid bones and surrounding tendons. This treatment can be effective in reducing pain and promoting recovery.

Surgical Treatments

In cases where conservative treatments fail to provide relief, surgical intervention may be necessary:

Sesamoidectomy

- Procedure: Surgically removing one or both of the sesamoid bones to alleviate pain and improve function.

- Benefits: Effective in relieving chronic pain that does not respond to other treatments.

- Risks: Potential complications include infection, nerve damage, and changes in foot mechanics.

Prevention Tips

Preventing sesamoiditis involves taking several proactive steps:

- Proper Footwear: Wearing shoes with adequate support and cushioning.

- Gradual Increase in Activity: Slowly increasing the intensity and duration of physical activities.

- Regular Stretching: Incorporating foot and calf stretches into your routine to maintain flexibility.

- Strength Training: Strengthening the muscles in the feet and lower legs to support the sesamoid bones.

Conclusion

Sesamoiditis can be a painful and debilitating condition, but with the right management and treatment, it is possible to alleviate symptoms and return to normal activities. At Bondi Podiatry, we are dedicated to providing comprehensive care tailored to your specific needs. If you are experiencing symptoms of sesamoiditis, contact us today to schedule an appointment with our experienced team. Your foot health is our priority, and we are here to support you every step of the way.