(See also Overview of Foot Problems.)
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 (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 have sesamoiditis.
Symptoms
Diagnosis
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.
X-rays are taken and sometimes magnetic resonance imaging (MRI) is done to rule out arthritis, displacement, or a fracture of the sesamoid bone.
Treatment
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.
