What is Sesamoiditis?
Sesamoiditis is a form of tendinitis that specifically affects the sesamoid bones, which are two small, pea-shaped bones located in the ball of the foot, underneath the big toe joint. These bones are embedded within tendons and are subjected to immense pressure during walking, running, and jumping. Sesamoiditis is characterised by pain, inflammation, and sometimes swelling in the area around these bones.

Symptoms
Tenderness or sharp intense pain under the 1st toe joint on walking, particularly during the ‘toe off’ part of the gait cycle, when the pressure on the ball of the foot is greatest. Localised swelling may also be apparent.

Causes
Sesamoiditis is often associated with foot posture, excessive pronation (feet ‘rolling’ inwards), overuse or worn footwear. Other factors may include engaging in high-impact activities like running or dancing, wearing shoes that are either high-heeled or ill-fitted, having anatomical foot issues such as high arches, a sudden surge in activity level or change in training surface, and direct injury or trauma to the sesamoid bones.
Diagnosis
Diagnosis is typically made through a physical examination, patient history, and imaging tests like X-rays, ultrasounds, or MRIs to rule out fractures and other conditions.
Treatment
The main goals in treating sesamoiditis are to relieve pain and reduce inflammation. Common treatments include.
- Rest and avoiding activities that exacerbate the pain
- Ice application to reduce swelling
- Anti-inflammatory medications, such as NSAIDs, for pain relief
- Padding, taping, or strapping the big toe to offload pressure from the sesamoid bones
- Using orthotic insoles to redistribute foot pressure
- Physical therapy to strengthen the muscles and tendons around the sesamoid bones
In persistent or severe cases, corticosteroid injections or surgical removal of the sesamoid bones may be considered, although these options are generally considered last resort.
If you suspect you have sesamoiditis, it’s important to consult your podiatrist for an accurate diagnosis and appropriate treatment plan tailored to your specific condition. At Galleria Podiatry, we can provide you with information regarding appropriate footwear.
Pain of this type may also benefit from the use of pain relieving gels or LIFESOLES which can be found in our shop.
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