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Sesamoiditis: A cause of big toe joint pain

Sesamoiditis is a painful condition affecting the bottom of the big toe joint. The sesamoids are two small bones that are embedded in the tendon that runs along the sole of the foot into the big toe. Their role is to lever the weight of the body over the big toe joint during the walking cycle. Essentially they are a pulley system.

Sesamoiditis presents as pain under the big toe joint on the ball of the foot. Pain is exacerbated by pressure, such as hard shoes or floors, and activities involving force, such as running. Swelling and bruising may accompany the big toe joint pain, but not always. The big toe may also become stiff and difficult to bend.
If the pain develops quickly, this is known as acute sesamoiditis, and may in fact be a sesamoid fracture.
If the pain develops gradually, this is more likely to be caused by an individual’s biomechanics and foot posture.
To assess the condition, your podiatrist will palpate the area and check for tenderness directly over the sesamoid bones. They will make note of any abnormalities in your foot condition, such as high foot arches, bunions, claw or hammer toes, large gaps between toes, or flat feet. This will give clues as to the exact cause of the big toe joint pain, and will direct treatment later on. If the podiatrist is concerned about a fracture, they will refer you immediately for an x-ray or bone scan.
Treatment for sesamoiditis can begin immediately, regardless of whether there may be a fracture, so that recovery is speedy.
In 2 weeks we will be discussing different treatment options available for sesamoiditis. Stay tuned.
Laura RabjohnsSesamoiditis: A cause of big toe joint pain