Sesamoids: Small Bones that Cause Big Pain

Have you ever heard of sesamoids? They are small bones that are connected only to tendons or are buried in muscle. It is an uncommon structure which is only present in a few parts of the body—one of them being your feet. There are two sesamoids located on the bottom of your foot near the big toe. About the size of a corn kernel, the sesamoids create a smooth surface for the tendons to glide over and transmit muscle force. When all is working as it should, the sesamoids help with bearing the weight of your body and moving the bones in the big toe. However, when the tendons surrounding the sesamoids become inflamed, a painful condition known as sesamoiditis can develop.

Symptoms and Risk Factors

The first sign of sesamoiditis is pain in the ball of the foot, under the big toe. This pain may be dull and aching or more severe. It can come and go depending on your activities and your footwear. You may also notice swelling or bruising on the ball of your foot, as well as difficulty bending and straightening the big toe.

The inflammation is caused by excessive pressure to the sesamoids. At Southern Maryland Foot & Ankle, we often see this problem in patients who do activities that put stress on the ball of the foot, such as running, tennis, ballet, golf, football and baseball (specifically catchers). Having high arches and wearing high heels can also make you more prone to sesamoiditis.

Treatment

To diagnose sesamoiditis, our foot and ankle surgeon, Dr. Larry Hotchkiss, will physically examine your foot, focusing in on the big toe and assessing its range of motion. The foot doctor may also watch you walk and study the wear pattern of your shoe. Digital x-rays (which can be done in either our Waldorf or Clinton office) and other imaging studies may be ordered to get a better picture of the sesamoids and also to help rule out other possible conditions.

Usually, sesamoiditis can be cured by discontinuing activities that aggravate it, at least for some period of time, to give the bones and tendons time to heal. Icing the ball of your foot and using over-the-counter anti-inflammatory medication (like ibuprofen) will help relieve pain and inflammation. The podiatrist may also make recommendations about the types of shoes you wear and prescribe padding or orthotic devices to relieve pressure on the sesamoids.

If you are suffering from pain in the ball of your foot, make an appointment at Southern Maryland Foot & Ankle. Just “living with the pain” is not a good option and can lead to worse disability down the road.