A sesamoid bone is a small nub of bone that grows within a tendon or muscle, and acts as a stable pulley for the muscle or tendon, providing strength and stability. We all have sesamoid bones in our big toes (usually two in each big toe, although some people only possess one in each toe), and their presence is vital for stable walking and other physical activities. However, if you are suffering from a bout of sesamoiditis, these unobtrusive little bones may feel like your worst enemy.

What is sesamoiditis?

Sesamoiditis occurs when the sesamoid bones in your toe, as well as the tendons surrounding them, become inflamed and painful. It can occur in one or both toes.

What causes sesamoiditis? 

Sesamoiditis is caused by long periods of increased pressure on the sesamoid bones, and frequently affects athletes, dancers and other people who place their feet under intense and regular strain. It is often caused by a sudden and marked increase in the intensity of a sufferer's exercise routine, which places significantly more strain on the sesamoid bones and the tendons that surround them without given them a chance to adapt to the new regimen. It is also more likely to occur if you have particularly bony feet with thin, poorly-cushioned soles, or if you have particularly high foot arches that necessitate placing more pressure on the balls of the feet while moving.

What are the symptoms of sesamoiditis?

Sesamoiditis is generally characterised by a gradually increasing pain that occurs at and around the joint where the big toe meets the foot. It generally begins as a mild ache, and worsens gradually the longer it is left untreated, becoming an extremely painful and debilitating throb if neglected for long enough.

In rare cases, some bruising or redness may be noticeable around the affected tendons, but in most cases the gradually increasing pain is the only symptom of this condition, making it difficult to diagnose -- for this reason, it is very important to seek a professional podiatrist's opinion if you suspect you are suffering from this condition.

How can sesamoiditis be treated?

Once your podiatrist has inspected your foot and ascertained that you are suffering from sesamoiditis, they will be able to offer a range of treatments depending on your needs:

  • Pain relief: If sesamoiditis is causing you significant pain, you may be prescribed oral medications such as ibuprofen, and instructed to numb the pain by applying ice packs to the affected area. In cases of more severe pain, injections of corticosteroids may be administered, though only if deemed necessary. These measures are temporary, and will not help to correct the underlying problem.
  • Rest: Continued use of the foot during a bout of sesamoiditis will only result in the inflammation becoming more severe, so a period of strict rest is necessary.
  • Shoe inserts: Orthotic insoles crafted by a podiatrist can redistribute the weight placed on your foot while moving, taking pressure off the damaged sesamoids and allowing them to heal more quickly.
  • Taping and strapping: Using tape or straps to bind the big toe to the adjacent second toe will completely immobilise the big toe joint, allowing the damaged tendons to heal more quickly.