Merck Manual

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Sesamoiditis

By

James C. Connors

, DPM, Kent State University College of Podiatric Medicine

Reviewed/Revised Dec 2023
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Topic Resources

Sesamoiditis is pain around the two small bones (the sesamoid bones) below the metatarsal head where it adjoins the big toe (first metatarsal head).

  • 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.

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 Bunion 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.

Treatment of Sesamoiditis

  • New shoes

  • Orthoses

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.

NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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