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Sesamoiditis is pain in the sesamoid bones that lie beneath the big toe joint. Unlike other bones in the foot, sesamoids are not connected to other bones, but to the tendons and muscle around them.

Sesamoid bones have a smooth surface, allowing tendons to glide over them. They enable the muscles to work effectively, are important in weight bearing exercise and help to move the big toe. If the tendons around the sesamoids become irritated or inflamed, this is known as sesamoiditis (a form of tendinitis). Sesamoiditis is more common in ballet dancers, runners and some team sports players. When athletes injure the sesamoids this is known as turf toe injury (where the toe is bent backwards). Long term wear and tear of the big toe joint can cause big toe arthritis, which also leads to pain around the sesamoid bones.

What are the signs of sesamoiditis?

Signs include pain under the big toe around the ball of the foot. There may also be some swelling or bruising and it can become difficult to bend and straighten the big toe.

How is sesamoiditis diagnosed?

During your first appointment, you’ll have an opportunity to discuss your symptoms with Mr Heidari, who will be able to advise you on the best course of treatment. He may also arrange X-rays to check for fractures, as well as an MRI or CT scan.

What does treatment involve?

  • In many cases, resting, taking anti-inflammatory painkillers (if advised by your doctor), and resting the foot, along with regularly applying an ice pack can help relieve the pain. It’s a good idea to wear soft, comfortable shoes (a shoe insert can also help)
  • A shoe or insole that off-loads your weight away from the toe can help
  • You may be advised to avoid activities that put weight on the balls of your feet and, if necessary, that you wear a leg brace for around 4-6 weeks
  • Mr Heidari may suggest that you work with one of our team of physiotherapists on a personalised exercise programme
  • If the pain doesn’t improve, you may be able to have surgery to repair any fractures or remove the sesamoid bone that is causing the problem, enabling you to return to your normal activities

This information is written as a guide to your treatment but it is not intended to replace the advice of your doctor. Please contact us for advice if you are worried about any aspect of your health or recovery.