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What is a sesamoid bone?

A sesamoid bone is an independent bone embedded into a tendon. The most well-known sesmoid bone in the human body is the patella, or knee cap. Sesamoid bones provide a mechanical advantage to the joint, making them important for normal function.

The sesamoid bones are located under the big toe of each foot. Two small bones under the big to form the bunion joint in each foot. The word sesamoids comes from Greek, and translates as “sesame-seed like.

Sesamoiditis

Sesamoiditis is the name given to a condition that causes the sesamoids to become inflamed or irritated.

Typically, pain experienced from sesamoiditis comes about gradually. Initially pain will be eperiences when the big toe is put into a bent position (dorsiflexed), and the sesamoid bones are felt underneath. As the condition progresses, the area under the big toe will become tender with any activity.

In longstanding cases patients may report pain all the time. The pain is usually worse when the patient is on their feet. There may also be swelling and redness of the area.

There are many other possible causes of pain at this joint. Your podiatrist can help to diagnose the correct pathology.

Imaging, including  x-ray, ultrasound, or CT can be required to make a diagnosis.

Cause & Treatment

Sesamoiditis is often caused by inappropriate footwear, poor mechanics of the foot, structural differences of the sesamoids themselves, or because of repetitive impact to the area.

Sesamoiditis is typically treated by addressing the cause of pain. Rest, Ice, Compression and Elevation (RICE) may help. In addition your podiatrist can help to develop ways to appropriately offload the area through footwear, orthotics, padding, or strapping.