Treatment
If you are experiencing pain under the ball of your foot—especially beneath the big
toe—you may be dealing with sesamoiditis. This painful condition involves
inflammation of the small bones (sesamoids) beneath the first metatarsal joint and is
often linked to overuse or repetitive stress.
At the Yorkshire Foot Hospital we provide expert diagnosis and evidence-based
treatment options to relieve pain, improve function, and get you back on your
feet—comfortably.
What Is Sesamoiditis?
Sesamoiditis is an overuse injury that affects the two small, pea-shaped bones
embedded within the tendons under the big toe joint. These bones help absorb
impact and assist in the push-off phase of walking and running.
When these bones or the surrounding tendons become irritated or inflamed—often
due to repetitive pressure—it can lead to persistent pain and discomfort known as
sesamoiditis.
Common Symptoms of Sesamoiditis
Sesamoiditis typically develops gradually, and symptoms may include:
 Pain under the big toe or ball of the foot
 Swelling or bruising around the joint
 Increased discomfort when pushing off during walking or running
 Difficulty bending or straightening the big toe
 Tenderness when pressure is applied to the area
If left untreated, sesamoiditis can become chronic and lead to reduced mobility or
altered gait.
What Causes Sesamoiditis?
Sesamoiditis is most commonly caused by repetitive stress on the forefoot. Risk
factors include:
 Activities involving frequent toe push-off (e.g. running, dancing, jumping)
 High-heeled or poorly cushioned footwear
 Foot structure issues (e.g. high arches or flat feet) **link to flat foot page**
 Sudden increase in activity levels
 Occupations requiring long periods of standing or walking
Diagnosing Sesamoiditis

Diagnosis typically involves:
 A detailed clinical history and physical exam
 Palpation of the sesamoid bones and joint
 Gait analysis to assess walking pattern and load
 Imaging (X-rays or MRI) in cases where fractures or joint degeneration are
suspected
At the Yorkshire Foot Hospital our team uses a thorough approach to ensure
accurate diagnosis and effective treatment planning.
Treatment Options for Sesamoiditis
Most cases of sesamoiditis can be treated conservatively without the need for
surgery. Treatment may include:
Footwear Modifications: Switching to cushioned, supportive shoes with a wide toe
box can relieve pressure under the big toe.
Custom Orthotics: Orthotic inserts help offload the sesamoids and redistribute
pressure across the forefoot.
Physiotherapy: Targeted exercises, manual therapy, and load management
strategies to improve foot biomechanics and reduce inflammation.
Activity Modification: Temporarily reducing high-impact activities allows the area to
heal properly.
Ice & Anti-inflammatories: To reduce pain and swelling in the early stages.
Persistent cases may require immobilisation in a walking boot or further medical
interventions, though surgery is rarely needed.

Get Relief from Sesamoiditis
Don’t let forefoot pain slow you down. At the Yorkshire Foot Hospital, our team of
skilled clinicians offers personalized care to help you manage sesamoiditis, prevent
recurrence, and return to the activities you love—pain-free