Sesamoiditis | Foot Pain Caused by Sesame Seed Bones?

The tendons which run through the sesamoids can be easily aggravated with a rubbing movement causing inflammation and irritation to these structures. Ballerinas, baseball catchers and runners are most likely to develop sesamoiditis according to The American Academy of Orthopaedic Surgeons, but you don’t have to be an athlete or dancer to suffer from it. Wearing high heeled shoes, poorly fitted footwear and a high foot arch are also factors which can lead to sesamoiditis. 

Have you heard the story of the Princess and the Pea? This princess was so delicate, that even a single pea under a tower of thick mattresses was enough to disturb her sleep! It all sounds very silly, but you might be embarrassed to learn that we’re not much different, in a way.

Enter sesamoiditis – a condition which plagues the sesamoid bones at the front of the foot. So named for their resemblance to sesame seeds, they are a set of two bones located under the big toe which stabilize the entire foot. Sesamoiditis is when you feel a sharp pain, ache, or soreness at the specific area where these bones are, especially when you step off the ground as you walk. Continuing to walk or engage in activity will increase the pain until it becomes an intense throb.

They’re only two small bones, but sesamoid pain can be chronic and debilitating since those two little bones help to support the entire foot. Prevention is usually the best course of action and requires the victim to make major lifestyle changes in the meantime. First of all, since high heels put more pressure on the ball of the foot, you will need to make the switch to low-heeled shoes with firm, rubber soles. 

Reducing activity in general and getting adequate rest is also important, as they allow the sesamoids to rest more. If you can’t afford to stop, though, make sure that you wear the proper footwear for those activities. You will have to consider their capacity for shock-absorbance and structure, while also making sure that you replace them regularly so that they continue to support your foot well. Also make sure that you choose a comfortable, wide shoe, as wearing narrow, pointed shoes will likely aggravate your sesamoid pain.

If you are already suffering from sesamoiditis, our first-line treatments for you are mostly conservative in nature. Meaning, they are non-invasive, and generally involve added lifestyle changes on top of what’s recommended above. This includes wearing cushioning pads or special orthotic devices to help further support your feet – specifically, they would be placed under the ball of your feet and should be worn whenever possible. Depending on the case, we might also recommend steroid injections to help reduce swelling.

In severe cases, surgery to remove the sesamoid(s) entirely may be needed, especially if they have become fractured or otherwise damaged. Don’t let it get to that point! Book a consultation with us today to figure out a treatment plan for you.

Written by Mark B. Reyneker
Written by Mark B. Reyneker

Podiatrist 20 years of clinical experience. Practiced in South Africa, Malaysia, and Singapore. Pioneered CAD/CAM custom made orthotics in S.E Asia.

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