Symptoms include pain when walking (especially barefoot) or while wearing certain types of shoes.
The diagnosis is based on an examination of the foot.
Orthoses, offloading pads, and new shoes can help relieve pain.
(See also Overview of Foot Problems Overview of Foot and Ankle Problems Some foot problems start in the foot itself, for example, resulting from a foot injury. Problems can occur in any bone, joint, muscle, tendon, or ligament of the foot. Foot and ankle fractures... read more .)
Sesamoiditis is a common cause of pain in the ball of the foot Pain in the Ball of the Foot (Metatarsalgia) Pain in the ball of the foot is called metatarsalgia and may have many different causes (including arthritis, pinching of the nerves between the toes, posture problems, and various disorders)... read more (metatarsalgia).
The cause of sesamoiditis is usually repeated injury. Sometimes the bones are fractured, or the bones or surrounding tissues are inflamed. A change in the structure of the foot can sometimes shift the position of the sesamoids (displacement) 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 Bunion In people with a bunion, the joint at the base of the big toe appears to stick out (becomes prominent). Abnormalities in joint position or motion can distort and enlarge or seem to enlarge the... read more have sesamoiditis.
Symptoms of Sesamoiditis
The pain of sesamoiditis is felt beneath the base of the big toe (the first metatarsal joint). The pain is usually made worse by walking, particularly when wearing certain flexible thin-soled or high-heeled shoes. The area may be warm and swollen, and the big toe may be red.
Diagnosis of Sesamoiditis
A doctor's examination of the foot
For gout or infection, joint aspiration
For fracture, displacement, or arthritis, imaging tests
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 Joint aspiration (arthrocentesis) A doctor can often diagnose a musculoskeletal disorder based on the history and the results of a physical examination. Laboratory tests, imaging tests, or other diagnostic procedures are sometimes... read more or arthrocentesis) if gout Gout Gout is a disorder in which deposits of uric acid crystals accumulate in the joints because of high blood levels of uric acid (hyperuricemia). The accumulations of crystals cause flares (attacks)... read more or infectious arthritis Infectious Arthritis Infectious arthritis is infection in the fluid and tissues of a joint usually caused by bacteria but occasionally by viruses or fungi. Bacteria, viruses, or fungi may spread through the bloodstream... read more is suspected.
X-rays X-rays A doctor can often diagnose a musculoskeletal disorder based on the history and the results of a physical examination. Laboratory tests, imaging tests, or other diagnostic procedures are sometimes... read more are taken and sometimes magnetic resonance imaging Computed tomography (CT) and magnetic resonance imaging (MRI) A doctor can often diagnose a musculoskeletal disorder based on the history and the results of a physical examination. Laboratory tests, imaging tests, or other diagnostic procedures are sometimes... read more (MRI) is done to rule out arthritis, displacement, or a fracture of the sesamoid bone.
Treatment of Sesamoiditis
Not wearing the shoes that cause pain beneath the base of the big toe may be sufficient. If symptoms of sesamoiditis continue, however, using offloading pads as well as wearing 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 Nonsteroidal Anti-Inflammatory Drugs Pain relievers (analgesics) are the main drugs used to treat pain. Doctors choose a pain reliever based on the type and duration of pain and on the drug's likely benefits and risks. Most pain... read more (NSAID) taken by mouth and injections of a corticosteroid/anesthetic mixture into the affected area can help relieve pain.