Sesamoiditis

 

Sesamoiditis is a condition that affects the two small bones located beneath the joint of the big toe, and naturally, they are referred to as the sesamoid bones. The purpose of these bones it to stabilize the foot and protect the tendons during weight bearing activities, including walking. In fact, the sesamoid bones are crucial to the ‘pushing off’ phase of the gait cycle, and heavy usage is one of the factors that make them vulnerable to overuse and irritation, or sesamoiditis. Because the cartilage covering these bones becomes irritated and inflamed this condition is occasionally classified as a form of tendonitis.

Sesamoiditits often develops when there is too much pressure placed on these bones, or when there is direct injury to the tissues, joints, or bones found in the sesamoid area of the foot, however, this particular type of inflammation may also occur as a result of arthritis or a fracture to one or both bones. It is not usually an acute injury that causes this type of pathology to develop but rather repetitive motions that place excessive pressure on the forefoot.

Activities such as running, jumping, wearing high heels or participating in ballet all increase the risk for developing sesamoiditis, and bony feet and feet with high arches are much more vulnerable to this type of discomfort as well. Some foot types display unusually prominent sesamoid bones as well, and this increases the odds that the bones will be exposed to excessive pressures.

The first indication of inflammation is usually an aching sensation of pain that grows more acute if activity levels are not reduced. There may also be pain beneath the joint of the big toe, redness and swelling in the afflicted area, and the big toe may become stiff and slightly deformed. If the issue is not addressed the condition will likely get worse with time, and it often happens that people neglect sesamoiditis until normal activity levels and gait patterns are negatively affected.

Reducing activity levels and using cold compresses will help relieve discomfort and accommodate the healing process. Wearing high heels should be avoided and shoes should have adequate support and cushioning as well. Orthotic devices should be used as needed and a protective pad should be used in the area of the sesamoid bones, and while anti-inflammatories will help to relieve pain they should not be relied on for long-term treatment.

When non-invasive treatments are introduced early enough they are often enough to improve the condition within a short period of time. More advanced cases, however, may require the use of cortisone injections or long-term therapy that addresses the underlying causes. Sesamoiditis that has developed as a result of a sesamoid fracture will require more aggressive treatment overseen by a podiatrist or healthcare professional, and a cast may used for several weeks to realign and protect these fragile bones. Surgery is only performed if all other options have failed to remedy the condition, as it can cause as many problems as the original pathology.

Early treatment of sesamoiditis is necessary if more aggressive and invasive treatments are to be avoided. Foot care is a crucial component of general health care and foot pain should be addressed immediately upon development.

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