Pain in Big Toe and Ball of the Foot: Sesamoiditis Explained

Are you experiencing pain in or around the joint of your big toe, near the main ball of your foot? This is the portion of the foot located between your toes and your arches.

If so, there’s a possibility you might have a common condition called sesamoiditis. This condition involves pain and inflammation caused by too much stress on the tendons in the foot.

Read more about sesamoiditis below, including signs and symptoms, whether you might have it, and how an expert podiatrist may help you.

For personalised advice, contact our team at Modern Medicine today.

What is Sesamoiditis?

Sesamoiditis is a condition in which the sesamoid bones of the big toe and other structures in this area are inflamed.

Sesamoid bones are round bones connected to a tendon in the hand, wrist, knee or foot. They are pea or seed-shaped, which helps explain the name; it derives from the Latin word ‘sesamum’, meaning sesame.

There are two sesamoid bones in the foot: the medial sesamoid, which is closer to the middle of the foot, and the tibial sesamoid. They are both found in the base of the big toe, under the big toe joint and on the inside edge of the ball of the foot.

While these bones may be small, they play an important role in the foot – anchoring the tendons they are embedded in, and helping these tendons easily manage movements.

Sesamoiditis occurs in feet only, when tendons surrounding the sesamoid bones are put under stress, generally through overuse. This leads to painful inflammation in both those tendons and the sesamoid bones.

People Most at Risk

Most common physical activities – including walking, running and dancing – involve a movement in which weight is transferred to the ball of the foot. During this movement, the sesamoid bones absorb a lot of shock.

If this movement isn’t performed correctly due to structural issues, or if it is over-performed by eager athletes, there is a risk of sesamoiditis.

Here are some people who are at risk of developing this condition:

• • Athletes, runners and dancers who perform or practice certain movements too often. It may be the case that they overload their training, and go too hard with a new exercise too soon.
  • People with gait issues, or issues with how they walk or run. A common example of this is overpronation, or a tendency to roll the feet inward when walking.
  • People who have foot types with anatomical imbalances, e.g. those with very high arches or flat feet, or with big toes unusually positioned compared to other toes.
  • People who wear high heels, or shoes that are rigid and uncomfortable.
  • Other factors may contribute to this condition, including low bone density or excess body weight.

Sesamoiditis: Signs & Symptoms

Sesamoiditis gradually builds over time, with a range of symptoms that tend to come and go. The pain may be a long-standing dull and aching pain or more of a sharp sensation.

Here are some key signs of sesamoiditis to watch out for:

• • Pain around the ball of the foot and beneath the big toe joint, either with or without pressure applied
  • Pain extending or bending the big toe
  • Pain when undertaking weight-bearing activities or large load volumes, like jumping, running and dancing
  • Pain when wearing specific shoes or even when walking
  • Redness, bruising or swelling.

Diagnosis and Treatment

Sesamoiditis doesn’t look the same for every patient. It can be mild or more serious, and the recovery time can range from days to months, depending on the treatment required.

An assessment and diagnosis of sesamoiditis often follows these steps:

• Consultation: Your podiatrist or healthcare professional will ask you about your symptoms and examine your foot. Their focus will be on the big toe joint and surrounding area, including the ball of the foot. They may watch for signs of tenderness or reduced mobility.
• Further tests: Sometimes sesamoiditis is accompanied by an acute injury like a bone fracture. Your podiatrist may want to get a clearer picture of the area, including the impact of any previous injuries, by arranging an x-ray, CT scan, ultrasound or other imaging tests.
• Diagnosis and treatment: Your podiatrist will provide clarity on your condition and suggest treatment options.

If you have sesamoiditis, you may be provided with or referred to one or more of these treatment options:

• Ice and anti-inflammatory pain medication in the early stages
• Rest and elevation to keep the pressure off the injury
• Restriction or immobilisation, including strapping, taping or padding of the big toe, or a walking boot
• Oral medications like NSAIDs to help with inflammation and pain management
• Rehabilitative therapies, including physical and soft tissue therapy
• Home exercises to strengthen the foot and surrounding areas
• Footwear or orthotic devices to address gait or anatomical issues
• Steroid injections or surgery to remove one of the sesamoid bones, but only in rare severe cases with no signs of improvement over time.

Fortunately, most people with sesamoiditis show immediate signs of improvement once they stop the activities triggering the stress on the joint. With support and guidance from their podiatrist, they can also usually return to those activities post-recovery with no issues.

If you see signs of sesamoiditis, it’s important to seek professional advice as soon as possible and to take your recovery seriously. Without the right attention, this condition can become chronic or cause permanent damage.

Our Podiatrists Can Help You Beat Toe and Foot Pain

Are you experiencing pain in the foot, particularly near your big toe? One of our friendly podiatrists can assess your symptoms and get to the bottom of your toe pain problem.

We provide a range of podiatry services for adults and children in the Ballarat region, including assessments and treatment for sesamoiditis.

For more information or to discuss your symptoms, book in to see us here.

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