Sesamoiditis
This series of educational material is a broad overview of foot problems, and not as detailed as an actual podiatrist visit. I recommend you to see a podiatrist for professional evaluation of your foot and ankle problems. This is for educational purposes only.
This material is from my own experiences seeing patients. Other podiatrists may have different recommendations. Each examination has nuances and details too small to mention in this type of presentation.
What is Sesamoiditis?
Underneath the first met head are two bones inside a tendon that help provide leverage. When too much pressure has been applied to this area the bones and tendons can become inflamed. This painful condition is called sesamoiditis.
Causes
Repetitive pressure or trauma to the forefoot in activities such as running, dancing, soccer, football, and tennis.
PIC
Symptoms
Pain under the 1st met head with weightbearing and pushing the big toe down against the ground.
Pushing the foot off the ground to walk or run forwards.
Swelling
Redness
Bruising
Treatment
First the problem must be identified correctly. This generally involves x-rays and in some cases MRI.
Treatment consists of taking weight off the painful area and removing stress from the painful parts. You also want to decrease the inflammation. How do you do this?
Stop doing, or decrease the activity, that causes pain.
Apply a dancer’s pad or get a custom shoe insert that removes pressure from under the 1st met head.
Ice 2x day 10-15 mins each
NSAIDs or topical Voltaren (diclofenac)
Some podiatrists will recommend steroid injections.
If the problem started recently, it usually gets better in 2-3 weeks. If the problem started months or years ago it may take months to improve.
More intense treatment can involve wearing a CAM boot to remove as much pressure as possible. This is only recommended in the more severe cases.
In the most severe cases surgery is performed to remove sesamoid bones or fix a fractured sesamoid bone..