Sesamoiditis is a condition observed as inflammation and pain around the little sesamoid bones under the big toe joint. These bones are two little, pea-shaped and size bones situated below the base of the great toe or hallux in the feet. These sesamoid bones behave as levers, providing leverage to the tendons which help move the great toe or hallux in the same manner that the patella acts as a pulley at the knee. Sesamoiditis generally evolves progressively and it is usually due to recurring pressure or too much use of the foot. The primary causes are usually this excessive use and recurring stress. Physical activities which involve repetitive pressure or impact on the front foot, such as basketball, jogging, dance, or bouncing, could bring about the cause of sesamoiditis. Those high-impact sporting activities which involve fast and forceful motions, such as basketball or tennis are more likely to add to the risk because the ball of the foot in which the sesamoid bones are is the place you rotate on the foot. Traits for example having a high mid-foot (arch), prominent or enlarged sesamoid bones, or excessive inward rolling of the foot (overpronation) might place additional force on the sesamoid bones. Using footwear that don't have enough padding, support, and have a tight toe box also can bring about sesamoiditis by increasing stress on the ball of the foot.
The main sign of sesamoiditis is localized pain underneath the base of the big toe on palpation. This pain may be described as a dull, aching, or pounding and frequently gets worse with more activity. The affected region beneath the ball of the foot might appear inflamed, reddish, or warm to touch. There could be difficult taking weight. Usually walking or bearing weight on the ball of the foot can be painful.
The main approach to the treatment for sesamoiditis is rest and also exercise changes. Physical activities really need to be decreased or avoiding exercises that worsen the discomfort is important to permit the sesamoid bones to heal. Modifying to lower impact exercise movements and incorporating some cross-training exercises can help preserve fitness with out putting too much force on the injury. Using ice packs to the affected region more than once each day can help reduce inflammation and pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) like advil can help reduce discomfort and reduce inflammation when it becomes too painful. Making use of footwear with good shock absorption and support, particularly in the ball of the foot area, will help reduce pressure on the sesamoid bones. Foot supports could be advisable to provide added padding and correct structural problems. Using pads or cushions beneath the affected area will help relieve stress and reduce the discomfort. In some cases offloading devices, such as a moon brace or crutches, could be needed in severe situations to allow full rest. In some cases which are not resolving to the strain reduction therapy, corticosteroid injections could be used to lessen pain and inflammation. Surgical procedures are not often necessary for sesamoiditis with the exception of the worst instances when the conservative treatments tend not to offer relief and the soreness is chronic or considerable deterioration continues to be done to the sesamoid bones. The surgical treatment requires the surgical removal with the impacted sesamoid bones and should be considered as a last measure.