Sesamoiditis: A Tiny Bone Causing Big Foot Pain

Most people have never heard of the sesamoid bones… until they start hurting.
If you’re feeling a sharp, aching pain right under the ball of your foot, especially beneath the big toe, you might be dealing with sesamoiditis.

The name may be a mouthful, but the condition is surprisingly common—and treatable. Let’s break down what’s happening, why it hurts, and how we help you get back on your feet.

What Is Sesamoiditis?

Your sesamoids are two tiny bones located under the joint of your big toe. Unlike most bones in the body, sesamoids aren’t connected to other bones—they’re embedded in tendons, helping absorb pressure and support movement in your forefoot.

Think of them like the kneecaps of your foot. Small, but incredibly important.

Sesamoiditis is simply inflammation of these bones and the surrounding tendons.
It’s usually caused by overuse, repetitive pressure, or a sudden impact.

Common Symptoms

You might have sesamoiditis if you’re feeling:

• Pain in the ball of your foot, especially beneath the big toe

• Swelling or bruising in the area

• Pain that worsens when pushing off the toe while walking or running

• Tenderness when pressing on the area

Some people even mistake it for a stress fracture—but sesamoiditis often builds gradually rather than coming from a single injury.

Who’s at Risk?

Sesamoiditis can affect anyone, but it’s more common in:

• Runners and dancers

• People who wear high heels or unsupportive shoes

• Those with high arches or bony feet

• Athletes in high-impact sports (like basketball or tennis)

Basically, if your forefoot takes a lot of pressure—you’re at higher risk.

How Podiatrists Treat Sesamoiditis

The good news? Most cases don’t require surgery. At Foot & Ankle Associates of Southern NH, we focus on conservative, effective treatment first.

Here’s what that usually looks like:

1. Rest and Activity Modification

Taking pressure off the foot is key. We may recommend a break from high-impact activities while healing begins.

2. Padding or Taping

We can apply padding or tape to offload pressure from the sesamoid area and reduce strain on the joint.

3. Custom Orthotics

These provide targeted support and cushioning to relieve pressure under the ball of your foot.

4. Anti-Inflammatory Treatment

Ice, oral medication, or even laser therapy may be used to reduce inflammation and speed up recovery.

5. Proper Footwear Guidance

Supportive shoes with stiff soles can help reduce flexing of the toe joint, which often aggravates symptoms.

When Is Surgery Needed?

In rare, chronic cases—especially when the bone is fractured or severely inflamed—surgery may be considered. But with early care, most people recover well without needing it.

Don’t Ignore Ball-of-Foot Pain

Even small bones can cause big problems when they’re under constant stress. If you’ve been dealing with pain near your big toe for more than a few days, it’s time to get it checked.

At our clinic, we’ll evaluate your symptoms, take imaging if needed, and walk you through a plan to relieve pain and prevent it from coming back.

Let’s get you walking comfortably again.

Book a visit today—we’re here to help your feet feel better, one step at a time.