Footcare Scotland - The Foot & Ankle Experts
pain in the ball of the foot


The sesamoid bones are two small bones that sit directly underneath the big toe joint.  The bones themselves sit within a tendon and help the toe joint move correctly.  Sesamoiditis is a painful condition that affects these bones, and causes pain on the underside of the big toe joint. 


What causes sesamoiditis? 

The sesamoid bones can be injured in a number of ways. 

  • They can be acutely injured or even fractured via direct trauma. 
  •  The sesamoid bones can become irritated and inflamed when the load exerted on them is too great.  
  • Arthritis affecting the big toe joint can also affect the sesamoid bones. 

 What are the symptoms of sesamoiditis? 

The most common symptom is pain underneath the big toe joint.  Where an acute injury such as a fracture is the cause of pain, symptoms are often severe and sudden.  There is often swelling or bruising surrounding the joint and you may have pain even at rest. 

Where the sesamoids are inflamed or irritated, your symptoms will be less severe and will have gradually worsened over a period of time.   Wearing thin soled or high heeled shoes will make the symptoms worse.  Symptoms will generally worsen during activity and improve with rest. 

 How is sesamoiditis diagnosed? 

In most cases, a good history taking and thorough examination is all it needs to diagnose sesamoiditis.  Where the diagnosis is not clear, we may order x-rays or an MRI scan.   

 How should I treat sesamoiditis at home? 

If your symptoms are severe and have occurred as a result of trauma, seek medical advice straight away.  If your symptoms have developed over a period of time, reduce or stop the activities that make it painful, apply ice regularly and wear a shoe that doesn’t bend too easily.  Where your calf muscles are tight, try stretching your calf muscles twice a day.    If your symptoms fail to resolve, see your local sports Podiatrist. 

 What will the Podiatrist do? 

First of all, our Podiatrist will help correctly diagnose the issue before agreeing a treatment plan with you.  In the first instance, this may include, padding and strapping, ice and footwear modifications.  If this isn’t sufficient to settle your symptoms we may recommend specially designed insoles (orthotics) to help offload the painful sesamoids and allow them to heal.  Conservative treatment is generally very successful in treating sesamoiditis.  However, where this fails, we will refer you to our Orthopaedic Foot & Ankle surgeon to discuss your options.   


If you have sesamoiditis and would like to book an appointment with one of our expert Podiatrists, you can do so by clicking the HERE