Below the big toe joint are two small bones referred to as the sesamoid bones. These seasmoids are embedded in tendons in the same manner the patella bone is with the anterior of the knee joint. The functionality of these sesamoid bones (and the patella) is thought to be to provide the tendons a more efficient lever to move the great toe joint. As these sesamoid bones are underneath the great toe joint, these are generally exposed to a considerable amount of pressure whenever walking and taking part in sport. Physical activities like the game of tennis where you must use the great toe joint to rotate on applies an enormous amount of pressure upon them. If these kinds of loads tend to be too high, it is possible to end up with a disorder termed sesamoiditis where these tiny sesamoids and the structures about them turn out to be painful. Using larger heels footwear in addition applies force over the sesamoid bones and so can needing to stand all day at work, in particular on hard flooring surfaces.
The signs and symptoms of sesamoiditis tend to be progressively increasing levels of pain under the big toe or hallux joint. When you push where these sesamoid bones are they can be very uncomfortable. In some cases the sesamoids have become notable since there has been some atrophy of the fat pad. Sometimes, particularly if the beginning of pain can be sudden there may be a stress fracture of one or both of the bones. There are a number of problems that can impact the large toe joint for example gout or osteoarthritis that also has to be taken into account when assessing a person with pain in this area.
Once a sesamoiditis has been diagnosed then sesamoiditis treatment generally gets underway with some sort of decline in activities or modifying them if that is achievable. Getting into well padded and support shoes are another helpful plan. There are self adhesive felts that can be adhered to the foot to get pressure from the uncomfortable spot. Pads could also be used on insoles in the footwear. Over the long term foot orthotics having pressure relief are generally very useful.
