Foot Pain by Location

Thank you for your question, Peter! We’re sorry to hear that you’re suffering from sesamoiditis. We understand how painful this problem can be and the degree to which it can affect your ability to perform weight-bearing activities. Considering the relatively small size of the sesamoid bones, the discomfort that’s sometimes associated with them can have an outsized effect on your well-being and quality of life. Fortunately, we’ve found that natural treatment approaches can be quite helpful for this problem in many cases. We’ll list some conservative care approaches here, but first, a little background on this common foot and toe issue.

Sesamoiditis occurs when the two floating bones beneath the base of the big toe (corn kernel-sized bones called sesamoids) are forced to deviate from their natural position and then become inflamed or irritated. Sesamoiditis is an overuse injury that involves chronic, or long-term, inflammation of the sesamoid bones and the tendons that act on these bones. Conventional footwear plays a prominent role in aggravating the sesamoids and their surrounding structures. Shoes with tapering toe boxes and toe spring can cause the sesamoids to become dislocated, causing dysfunction. When the hallux, or big toe, is properly aligned with the first metatarsal bone, the sesamoids are also properly aligned in their grooves and function as nature intended.

In our experience, we’ve found the following noninvasive methods to be helpful in resolving sesamoiditis:

Shoe Therapy: Wearing foot-healthy footwear that permits proper toe splay, and therefore a more even distribution of bodyweight across the forefoot, can be a good frontline approach to addressing this problem.

Correct Toes: Wearing Correct Toes toe spacers helps enable optimal toe splay and bodyweight distribution across the forefoot.

Immobilization: Temporarily placing the affected foot in a conventional cast or a removable walking cast can help the injured or irritated tissues rest and recover. Crutches can help reduce the amount of force on the sesamoids and may be helpful in some cases.

Taping or Strapping: Taping or strapping the involved toe may help reduce tension on the sesamoid bones.

Padding: Adding a special pad inside the shoe can help cushion the sesamoid bones. This pad, called a metatarsal pad, helps return the forefoot fat pad to a position that supports and protects the sesamoids.

Physical Therapy (PT): PT is an important treatment measure for sesamoiditis, especially following immobilization. Range-of-motion exercises and ultrasound therapy are among the most commonly used PT modalities for this health purpose.

For more info about natural strategies to address sesamoiditis, we recommend that you check out our blog post called Sesamoiditis: Conventional vs. Natural Approaches (www.naturalfootgear.com/blogs/educational-articles/sesamoiditis-conventional-vs-natural-approaches). Also, just FYI: Anti-inflammatory medication and cortisone injections are more aggressive approaches for treating sesamoiditis, though they may be necessary in some individuals. A foot care professional may also recommend surgery, including sesamoid bone removal, if conservative care measures fail to resolve this health problem.

Of course, it’s always important to be evaluated by a foot care practitioner to better understand the underlying nature of the problem and to receive the most personalized care possible. And we always recommend doing so before adopting any active measures intended to address or prevent foot and toe problems, including sesamoiditis. We hope this info helps! Please let us know if you have any follow-up questions.

Yours in Foot Health,
Drs. Marty & Robyn Hughes