What’s Causing Pain In The Ball Of My Big Toe?

Are you dealing with pain and discomfort in the ball of your big toe? If so, you may be dealing with a condition known as sesamoiditis, which involves an issue with the sesamoid bones in your foot. These tiny bones are connected to muscles by tendons, and if these tendons become inflamed, localized pain can develop. In today’s blog, we take a closer look at sesamoiditis and how the condition is typically treated.

The Causes And Symptoms Of Sesamoiditis

These unique sesamoid bones can be found in your hands, toes and knee, and they work to help decrease stress and stabilize the tendon they are attached to. In the foot, you have two pea-sized sesamoids that are housed in the ball of your foot underneath your big toe joint. Problems tend to develop when the tendons these bones are attached to become overstressed, which is why sesamoiditis is common in athletes, dancers or anyone who significantly increases strain on their feet in a short period of time. Acute injury to the foot can also lead to inflammation of the tendons that are attached to the sesamoids, but overstress is by far the most common cause of sesamoiditis. Overstress can also be the result of poor shoe choice that puts excessive strain on your foot, like if you regularly wear high heels or shoes that put more strain on your forefoot.

Symptoms of the condition include:

  • Pain under the ball of the foot
  • Swelling
  • Bruising
  • Tenderness
  • Difficulty bending or straightening the toe
  • A popping sensation under the toe when walking

Diagnosing And Treating Sesamoiditis

If you’re dealing with any of the above symptoms, consider setting up an appointment with your primary care physician or a foot specialist like Dr. McDonald. Your doctor will begin by listening to you describe symptoms, checking your medical history and taking a closer look at your foot during a physical exam. Your doctor may have a hunch that you’re dealing with sesamoiditis if there are tenderness and flexibility limitations in your big toe, but they may opt to confirm their suspicions with the help of an X-ray or MRI. These imaging tests can rule out fractures or take a closer look at the soft tissues in the area.

If sesamoiditis is confirmed, your doctor will then take a moment to discuss your treatment options. Oftentimes tendon inflammation responds well to simple conservative treatments, so most people can put their sesamoid-related pain behind them by making a couple lifestyle adjustments. Treatment tends to focus on the underlying reason for sesamoiditis onset, meaning that your doctor may recommend:

  • Footwear Changes – Switching away from heels or other problematic footwear options to a more comfortable and supportive shoe can take pressure off the big toe tendon and work to calm inflammation.
  • Activity Restrictions – Short-term activity restrictions can help to relieve sesamoiditis. Activities that involve jumping, pushing off or landing heavily on the balls of your feet should be avoided while your tendons recover.
  • Icing – Icing your feet after activity or an extended period on your feet can help to calm inflammation and prevent symptoms.
  • Anti-Inflammatories – Anti-inflammatory medication can also help to relieve tendon inflammation. These may be most helpful if taken before or after activity.
  • Orthotic Inserts – Orthotic shoe inserts can change how pressure is dispersed on your feet, shifting stress away from the ball of your foot. This can help protect the area and allow inflammation to resolve.

Most people who follow a combination of the above techniques experience great results, but in severe or rare cases, a minimally invasive procedure may be recommended. During surgery, one of the two sesamoid bones is typically removed, as removal of both sesamoids can lead to other issues for the tendon. Your physician can walk you through this procedure in greater detail should it become necessary, but the vast majority experience enough symptom relief with conservative techniques that surgery is not necessary.

For more information about sesamoiditis or treating pain underneath the ball of your foot, reach out to Dr. McDonald’s office today at (860) 244-8889.

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