What is Sesamoiditis?


The quick answer, Sesamoiditis is a painful foot condition that causes inflammation of the sesamoid bones in the foot and its surrounding tissues. Sesamoiditis develops when your sesamoid bones, the two very small bones located under the big toe joint, are irritated or injured due to overuse and repetitive impact from activities. Sesamoiditis can cause a dull ache or sharp pain under the big toe or pain in the ball of the foot, especially when putting weight through the big toe.

X-ray of the sesamoid bones showing where sesamoiditis occurs in the human foot anatomy. JOI RehabX-Ray of Sesamoiditis in the Sesamoid Bones

The following are factors that can contribute to Sesamoiditis.             

  • activities that requiring being on the toes (i.e. running, dance)
  • frequently wearing high heels 
  • naturally high arched feet 
  • abnormally large sesamoid bones. 

Where does Sesamoiditis hurt?

The pain from Sesamoiditis occurs at the ball of the foot, beneath the big toe joint. where the sesamoid bones are located. These bones are embedding in a tendon and help provide leverage to those tendons that help control the movement in the big toe. 

How long does Sesamoiditis take to heal?

In mild cases of Sesamoiditis, you can normally start to feel better within a few days of beginning treatment (resting, icing and doctor advised anti-inflammatories). However, like any injury, the time it takes to heal depends on the severity of the injury. If your symptoms do not lessen within a week or two, your doctor may recommend other forms of treatment which will in turn, prolong your recovery time.

How do you treat Sesamoiditis?

Sesamoiditis treatment is based on the symptoms your experiencing but typically the initial treatment involves relieving the pain you are feeling. This can be done by alleviating the pressure away from the sesamoid bones and can be accomplished by using ice, anti-inflammatories and temporarily discontinuing the activity or activities that are causing your pain. Once the pain has decreased, the next step of treatment is to work on improving any contributing factors that are causing Sesamoiditis to prevent future triggers. 

Treating Sesamoiditis with Physical Therapy

Your doctor may prescribe Physical Therapy to work on improving flexibility and strength in your foot and ankle. In some cases foot padding or orthotics may be prescribed to take the pressure off of the sesamoid bones. Changing foot wear and making sure you are wearing shoes that support your arch can help decrease the risk of recurring symptoms. If Sesamoiditis is severe, your doctor may require to wear a walking boot for 2-6 weeks, consider injections, or in very severe cases, surgery. 

Oftentimes the best treatment for Sesamoiditis is avoiding or altering the activities that trigger it. 

Physical therapy stretches for Sesamoiditis. JOI RehabBig Toe Stretch for Sesamoiditis

Is Massage Good for Sesamoiditis? 

While it is not advised to massage directly over the sesamoid bones, gentle massage of the area around the sesamoid bones can help to improve blood circulation to the sesamoid bones, which can help to speed up recovery time. Massage can help to decrease the tight spots found in your foot which can help to improve flexibility of the muscles in the foot which then in turn can relieve some of the pressure felt from Sesamoiditis.    

Is Sesamoiditis permanent?

If the sesamoid bones become inflamed and is left untreated for a prolonged period of time, there is a chance that permanent damage can occur to the sesamoid bones. There is always a chance to re-trigger Sesamoiditis; however, if treated in the early stages, it can be managed. It is important to start your treatment in the early stages to avoid permanent damage so that you can get back to your normal activities as quickly as possible. For some, a lifestyle change might be required, like taking the time to rest and ice after strenuous activities or avoiding those activities that trigger Sesamoiditis in the first place. 

How can I Prevent Sesamoiditis?

The best way to prevent Sesamoiditis is to wear shoes with proper support.  Custom orthotic inserts through Footmaxx may also decrease the risk of irritating the sesamoid bones if there are issues with the arch and foot posture.

JOI Custom Orthotics can help with foot problemsCustom Foot Orthotics

You can also ask a doctor about having a gait analysis performed to determine if you are prone to Sesamoiditis or any other issue. 

By: Sonya Thigpen, PTA, ATC      

Book an Appointment with The Jacksonville Orthopaedic Institute Today!

Jacksonville Orthopaedic Inst. (JOI) offers gait analysis and custom orthotic fabrication.  We can help! JOI is the Official Sports Medicine Provider for the Jacksonville Jaguars.  To read more about the sesamoid bones, please go to: displaced sesamoid bone.

JOI Physicians continue to offer online new patient appointments. This is another option to make it more convenient to make new patient appointments with less phone hold times. Follow the link below to select your JOI MD and schedule online.

Related Articles:

Foot Pain in the Morning

 Home Remedies for Foot Pain.


Ligaments in the foot/

Bones in the toes/

Foot anatomy/

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To make appointments with JOI Rehab, please call 904-858-7045.


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