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Sesamoiditis-All you need to know, pain under the big toe!

Are you experiencing pain under your big toe? Unable to walk or run because of the pain? You might need to continue reading this article. 

Why am I having pain under the big toe?

Sesamoiditis is of the small sesamoid bones under the base of the big toe. It is an overuse injury causing gradual pain in the forefoot. You are particularly at risk if you have had a sudden increase in forefoot weight bearing activities.

The sesamoids are special bones in the body. They’re not connected to any other bone at the joint. Instead, they act as pulleys to aid tendon movement. Two of these sesamoids are present under the forefoot near the big toe. Sesamoids in the forefoot help with weight-bearing and lift up the bones of the big toe.

Let’s learn about the symptoms and causes of sesamoiditis, as well as how you can treat this condition at home.

Signs and symptoms
  • Gradual onset pain in the forefoot, especially when weight-bearing.
  • Tenderness over the under surface of the joint.
  • You may limp or shift your weight onto the outside of the foot when walking.
  • Swelling and inflammation.
  • Pain may be recreated when moving the big toe against resistance.
What causes sesamoiditis?

The sesamoid bones can become irritated with activities that involve repetitive forces to the forefoot such as dancing or running. Also, if foot mechanics are altered (you over-supinate or you wear high heels often) this can also transmit excessive force through the sesamoid bones causing inflammation. If you think you might have sesamoiditis it’s important to seek help from a physiotherapist or orthopaedics.

Can physiotherapy help to relieve the pain?


The physiotherapist applies treatments to the painful area to help control pain and swelling. These treatments involve the use of Ultrasound, Moist heat and soft-tissue massage. For faster recovery, the hallux may additionally be padded, strapped, or taped to immobilize and provide protection.

Here are few ways to treat your sesamoiditis:

  • Reduce or stop activities that are causing the pain, including sports and running
  • Take over-the-counter pain medication to reduce pain and inflammation
  • Apply ice for 10 minutes every 3 hours to reduce swelling
  • Wear low-heeled, soft-soled shoes
  • Add an insole to provide additional cushioning inside your shoes
  • Refrain from wearing high-heeled shoes to prevent future irritation and inflammation of the tendon
  • Wear shoes that provide adequate support when you resume normal activities
How to prevent sesamoiditis?

To help prevent sesamoiditis it is important to wear shoes that fit properly and support the arches of your feet. This also means replacing old shoes, especially work out shoes that are worn out.

Another good way is to maintain the flexibility of your muscles, do warm up and stretch before your activity.

If the problem is persistent for more than a month, please consult a specialist physio to look at a variety of other issues that can contribute.