Sesamoids are bones that are found in locations where a tendon passes over a joint, such as the hand, knee, and foot. They act in a functional way to protect the tendon and to increase its mechanical effect.
The sesamoids in the foot are found under the big toe and are located within the tendons that pass through this area. Sesamoiditis is when these bones become inflamed resulting in pain under the big toe joint.
Sesamoids, although less common can occur under the little toe joints and symptoms will present the same way as under the big toe.
Causes of Sesamoiditis (Pain Under The Big Toe):
- Fat Pad Atrophy (deterioration and thinning of the fat pad).
- Dancing barefoot or in shoe with thin soles.
- Squatting for long periods of time.
- Increased pressure on the balls of the feet (running, jumping).
- Wearing high heel for long periods of time.
- Biomechanical abnormalities (plantar flexed big toe, causing it to be the lower than the other forefoot bones and forcing it to bear more of the body’s weight).
- Excessive rolling in of the feet that cause increased loading to this area of the foot.
Symptoms of Sesamoiditis (Pain Under The Big Toe):
- Gradual onset of pain under the big toe and little toe joints.
- Increased pain under the big toe when weight bearing.
- Difficulty and pain when bending the big toe joint.
- Swelling and bruising may or may not be present.
- Formation of callus under the big and little toe joints, depending on pressure.
Treatment for Sesamoiditis (Pain Under The Big Toe):
- Stop the activity that is causing pain (barefoot dancing, alternate foot to squat on etc.).
- Rest and ice the area.
- Change footwear with soft sole and low heel.
- Use cushioning pads (i.e forefoot pads).
- Foot Mobilisation Therapy
- Orthotics to correct biomechanical abnormalities and reduce pressure, prescribed by Well Heeled Podiatry.
- Dry Needling.
- Surgery (Sesamoidectomy).