Sesamoiditis is pain around the two small bones (the sesamoid bones) below the metatarsal head where it adjoins the big toe (first metatarsal head).
Sesamoiditis is a common cause of pain in the ball of the foot (metatarsalgia).
The cause of sesamoiditis is usually repeated injury. Sometimes the bones are fractured (see Figure: Where Foot Fractures Occur), or the bones or surrounding tissues are inflamed. A change in the structure of the foot can sometimes shift the position of the sesamoids and cause pain.
Sesamoiditis is particularly common among dancers, joggers, and people who have high-arched feet or frequently wear high heels. Many people with bunions have sesamoiditis.
The doctor bases the diagnosis of sesamoiditis on an examination of the foot.
The doctor uses a needle to remove a sample of joint fluid (called joint aspiration or arthrocentesis) if gout or infectious arthritis is suspected.
The diagnosis may be confirmed by x-rays taken to rule out arthritis or a fracture of the sesamoid bone.
Not wearing the shoes that cause pain may be sufficient. If symptoms continue, however, shoes with a thick sole, low heels, orthoses (devices placed in the shoe), or a combination help by reducing pressure on the sesamoid bones.
A nonsteroidal anti-inflammatory drug (NSAID) taken by mouth and injections of a corticosteroid/anesthetic mixture into the affected area can help relieve pain.