Sesamoiditis: Symptoms, Diagnosis and Treatment
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Sesamoiditis is primarily an inflammatory condition of the sesamoid bones. It is challenging to manage as it can be irritated by walking and standing. As a result, it takes 3 months to heal and is managed correctly by a Physical Therapist, but irritable cases of Sesamoiditis can last for 12 months.
Treatment should include off-loading the foot, wearing cushioned trainers, applying ice, taping and anti-inflammatories.
The sesamoid bones sit on the underside of the big toe joint and bear weight when standing, walking and running, making it a tricky condition to manage effectively. Sesamoiditis taping and padding can reduce the load being placed through the sesamoid bone during these activities, reducing inflammation levels while maintaining a certain activity level.
When walking or standing, patients with Sesamoiditis feel a burning sensation under their big toe. Sesamoiditis can gradually occur, or you can have an acute episode if there is a sudden increase in activity levels. In acute episodes of Sesamoiditis, patients often feel a throbbing sensation in the evening and burning pain with use.
Sesamoiditis will go away in mild cases within 2 weeks if managed correctly with home care treatment. In more severe cases of Sesamoiditis, it can take 3-12 months to go away, but most cases of Sesamoiditis can be resolved with Physical Therapy Exercises.
Turf Toe is a hyperextension of the big toe which irritates the joint, whereas Sesamoiditis is inflammation of one or both of the sesamoid bones that sit under the big toe. Turf Toe pain is usually in the entire joint, so it can be painful on the side and top of the joint, whereas Sesamoiditis is painful on the underside of the foot only.
Related Article: Turf Toe: Symptoms, Causes & Treatment
Metatarsalgia is inflammation of the joints at the base of the toes that mainly affects toes 2-5, but it can affect the big toe. Sesamoiditis is inflammation of the sesamoid bones under the big toe. It is unlikely that you have Metatarsalgia in the big toe joint but to tell the difference; the sesamoid bones sit slightly closer to the ankle joint under the big toe. In contrast, Metarsalgia is painful on the big toe’s joint.
Related Article: Metatarsalgia: Symptoms, Causes & Treatments
Sesamoiditis can be seen on an MRI. We expect to see some swelling (bone marrow oedema) around the sesamoid bones on an MRI if there is sesamoiditis. It should be smooth around the edges of the sesamoid bones on an MRI, and the edges are usually sharper if there is a fracture of a sesamoid.
Stretching the calf muscle and the foot muscles can elongate the tissues and increase the flexibility of the ankle joint. Stretching these muscles is good for Sesamoiditis as tight calf muscles can accelerate the transfer of weight onto the forefoot, which exacerbates the symptoms of Sesamoiditis.
Massage is an effective form of pain relief for Sesamoiditis. Loosening the soft tissue structures of the foot and ankle with deep tissue massage can increase the range of motion of these joints and take the pressure off the sesamoid bones. It is worth keeping in mind that massage provides very short-term pain relief and that Physical Therapy exercises are more effective at addressing the causes of Sesamoiditis. Massage can be from a therapist, or you can carry out self-massage on your calf and foot using a foam roller or massage gun.