How to deal with Sesamoiditis in the foot?

Sesamoiditis is a condition characterized by inflammation and pain in the small sesamoid bones. These bones are two small, pea-shaped and sized bones located beneath the base of the big toe in the foot. These sesamoid bones act as pulleys, providing leverage to the tendons that help move the big toe in the same way that the kneecap act as a pulley at the knee. Sesamoiditis typically develops gradually and is often caused by repetitive stress or overuse of the foot. The main causes is overuse and repetitive stress. Sports activities that involve repeated pressure or impact on the forefoot, such as basketball, running, dancing, or jumping, can contribute to the development of sesamoiditis. Those high-impact sports which involve quick and forceful movements, such as basketball or tennis are more likely to increase the risk as the ball of the foot where the bones are is where you pivot over the foot. Characteristics such as having a high arch, prominent or enlarged sesamoid bones, or excessive inward rolling of the foot (overpronation) can put additional stress on the sesamoid bones. Using shoes that lack adequate cushioning, support, or have a tight toe box can also contribute to sesamoiditis by increasing pressure on the forefoot.

The main symptom of sesamoiditis is localized pain beneath the base of the big toe on palpation. This pain may be described as a dull, aching, or throbbing and typically gets worse with more activity. The affected area under the ball of the foot may appear swollen, red, or warm to the touch. There may be difficult bearing weight. Often walking or bearing weight on the ball of the foot can be painful.

The primary approach to the treatment of sesamoiditis is rest and activity modification. Sports activities need to be reduced or avoiding activities that exacerbate the pain is important to allow the sesamoid bones to heal. Changing to lower impact exercises and incorporating some cross-training activities can help maintain fitness without placing excessive stress on the foot. Applying ice packs to the affected area several times a day can help reduce pain and inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help relieve pain and reduce inflammation if it gets too painful. Using footwear with good cushioning and support, particularly in the forefoot area, can help alleviate pressure on the sesamoid bones. Foot orthotics may be recommended to provide additional cushioning and correct biomechanical issues. Using pads or cushions beneath the affected area can help relieve pressure and reduce the pain. Sometimes offloading devices, such as a walking boot or crutches, may be necessary in severe cases to allow for complete rest. In some cases that are not responding to the load reduction treatment, corticosteroid injections may be used to reduce inflammation and pain. Surgery is rarely required for sesamoiditis except in the worst cases when the conservative treatments do not provide relief and the pain is persistent or significant damage has been done to the sesamoid bones. The surgery involves the surgical removal of the affected sesamoid bones and should be considered as a last resort.