What is Sesamoiditis?

Sesamoiditis is a condition that causes metatarsalgia or foot pain under the ball of the big toe joint. It is a result of inflammation when the sesamoid bones are injured. Sesamoids are a pair of oval-shaped bones that sits under the first metatarsal bone, and it plays a vital part in acting as a fulcrum to allow the tendon (flexor hallucis longus) to pull and flex our big toe effectively and efficiently.

If poorly managed, Sesamoiditis can lead to a stress fracture, fracture or even avascular necrosis (“dying”) of the sesamoid bones.

What is sesamoiditis? Why is my big toe joint painful? Straits Podiatry Singapore

Causes of Sesamoiditis

Sesamoiditis is typically caused by acute trauma, repetitive trauma or overloading (excessive pressure), resulting in inflammation of the sesamoid bones and their surrounding tendons. Sesamoiditis most commonly affects the medial sesamoid, which is the sesamoid bone close to the inner side of the big toe joint.

Risk Factors of Sesamoiditis

Risk factors of sesamoiditis include:

  • High-impact sports, especially jumping sports
  • Forefoot runners
  • Barefoot training
  • Dancers (e.g Ballet dancers)
  • Sudden increase in activity
  • Flat feet or high arch feet (pes cavus)
  • Calluses under big toe joint
  • Prominent bones at the ball of the foot
  • High heels
Sesamoiditis signs and symptoms. Straits Podiatry Singapore

Signs and Symptoms of Sesamoiditis

Signs and symptoms of Sesamoiditis include:

  • Pain at the ball of the big toe joint
  • Dull aching pain or throbbing pain
  • Pain worsens with activity or barefoot
  • Swelling or prominent soft bump present
  • Stiffness
  • Difficulty flexing or extending the big toe

Sesamoiditis Management in Singapore

The management for sesamoiditis typically involves taking pressure away from the sesamoid and allowing recovery. Sesamoiditis must be managed early to prevent fracture or avascular necrosis from occurring.

Management options for sesamoiditis in Singapore include:

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