Sesamoids are the small bones present in some body parts like hands and feet, knee cap is also a sesamoid bone present in the knee joint. In, feet sesamoids are usually present in the base of the big toe. These are the pea sized small round bones that don’t articulate with any other bone. These are either connected with some tendon or are fixed in some muscle.
The inflammation of sesamoid bones is called as sesamoiditis. The main role of sesamoid bones in the foot is to help transfer weight to the ground and they act as pulleys for the muscles to which they are attached. The presence of sesamoid help the tendons release their tension due to the using of sesamoids as pulleys. The inflammation of these small bones usually occurs in the people who over use their feet in physical activities like sports. The inflammation of sesamoids also causes the surrounding tendons to be inflamed as inflammatory substances spread around.
Causes of sesamoiditis:
The most common and most important cause of the irritation of sesamoids is the overuse of feet. The physical activities like running, dancing, playing football, volleyball or other sports puts great pressure on sesamoids as these are directly affected during push up and also face the ground directly. The high pressure causes irritation and inflammation of sesamoid bones. Some other repetitive impacts like wearing a high heel continuously also cause the swelling. The predisposing factors to develop sesamoiditis are less flexible feet and high arch of a foot. If the amount of fat is less in foot to act as a protective cushion, the sesamoids are easily irritated in this case.
Symptoms of sesamoiditis:
- Usually the symptoms of sesamoiditis appear gradually in a row if untreated. Major signs and symptoms of sesamoiditis are:
- Pain in the area below the big toe and ball of foot
- Swelling
- Redness
- Tenderness
- Bruising or skin discoloration
- Rigidity
- Loss of bending
- Worsening of pain on walking or standing
- Arthritis if untreated for longer time
- Fracture of sesamoids in severe cases
Diagnosis:
The diagnosis is made on the basis of the complete medical history, especially about the physical activities and a thorough physical examination of the foot. The symptoms of the sesamoiditis like swelling underneath the big toe, redness etc are checked. X-rays are not used as they don’t reveal much detail in this regard; rather MRI (magnetic resonance imaging) and CT scan techniques are used to confirm the diagnosis of sesamoiditis.
Treatment of sesamoiditis:
Using some conventional cure methods is almost always sufficient enough to cure the problem and surgery is not required. The foot must be given proper and complete rest for a reasonable time and if used, special shoe pads should be inserted in shoes to reduce the pressure on sesamoids. Shoe inserts are available that fulfill this purpose in a better way. Apply ice to reduce the inflammation. Wrap ice cubes in a cloth and apply on inflamed part for 15 minutes after two hours in severe cases to reduce inflammation. Anti-inflammatory drugs and pain killers are also given to get rid of pain.