If you have ever worn a pair of sandals, you have probably experienced a tiny rock or pebble getting wedged under your foot. Even the smallest of pebbles can be irritating and cause discomfort, leaving you with no option but to stop and shake it out. There are times however when toe pain arises from inside your foot, and this is not something a quick shake of the foot can solve. If you have been living pain under your big toe joint, it may be due to a condition called sesamoiditis, which stems from the irritation of two very tiny bones.
It is helpful to take an inside look to understand where the sesamoid bones are located and the function they perform. The sesamoids are small, pea-sized bones embedded in a tendon that attaches your big toe to the first metatarsal. There is a significant amount of weight put on your foot each time it strikes the ground, and these two bones help disperse that weight evenly across the ball of your foot. They also act as pulleys, providing power and leverage each time you push off for a step.
Because you use the ball of the foot for almost every movement and the sesamoids have such an important role, they are at risk for being injured like any other part of the body that is used over and over. The surrounding bone and tissues can become inflamed and the tiny bones themselves can even become fractured. When either of these symptoms occurs, the condition is called sesamoiditis.
Most often this condition is caused by excessive, repetitive pressure, and the symptoms usually develop overtime. Sesamoiditis is classified as an overuse injury—too much stress and pressure causes toe pain that continues to get worse without treatment.
Running pain can often be related to a sesamoid injury. If you are a runner, the repeated pounding of your feet on pavement can be too much for the foot to bear, and crouching down on the balls of the feet—as a baseball catcher does—can also be problematic. Other sports such as basketball, dancing, and gymnastics, where you may do a lot of jumping and landing on your feet, can also make you prone to injuring these small bones. Poor conditioning, increasing the frequency or intensity of your workouts too quickly, and wearing unsupportive shoes are also aggravating factors.
With an overuse injury like this, you may feel the pain come on gradually. It may feel better when you rest and act up again when you exercise. It may worsen to the point when you feel pain every time you walk and wear certain shoes. This injury will not improve on its own without intervention, and if you have sharp toe pain, so that you can’t even put weight on your foot, it is especially important that you seek immediate treatment.
If you have nagging or a sudden pain under your big toe joint, contact Dallas Podiatry Works so we can examine your foot and determine what is causing your discomfort. For sesamoiditis, the first step is most often to stop doing the activity that caused the problem. Resting will give your foot time to heal and icing will also help relieve pain and inflammation. We may suggest taping or bracing to alleviate pressure on the ball of the foot and prescribe a pain reliever or a steroid injection if appropriate. During the healing process, it is helpful to wear shoes with a soft sole and felt pads for extra cushioning. You will need to ease back into exercise slowly, so your foot is not re-injured. It may take some time, but with patience and our expert treatment you can get back on your feet and off the sidelines.
Dr. Joel W. Brook, Dr. David R. Northcutt, Dr. Irene Arroyo and Dr. John Baca specialize in sports injuries and conditions of the foot and ankle. For toe pain or any other concerns about your feet, contact Dallas Podiatry Works for an appointment. You can reach our Dallas, TX office at (972) 566-7474 or Plano, TX at (972) 943-3323.