Sesamoiditis is an inflammation of the sesamoid bone and the associated tendons. It is commonly seen in ballet dancers, sprinters and basketball players. It is an overuse injury caused by an increased pressure over the sesamoid bones resulting in a chronic inflammation.
Sesamoid are a special type of bone that are found in the knee, wrist and behind the big toe. Unlike other bones of the body, these bones do not articulate with other bones but are present under the tendons or embedded in the muscles. They provide a smooth surface over which the tendon can glide, increasing their ability to transmit muscle force. The knee cap or patella is the largest sesamoid bone in the body. Two small sesamoid bones are found on the underside of the big toe.
Trauma or injury is the most common cause of sesamoiditis; an injury to the soft tissues around the big toe joint and the sesamoid bone can result in sesamoiditis. Any acute injury such as muscle pull, ligament sprain, fracture of the sesamoid or the surrounding bones and a dislocation of the neighboring joints can result in sesamoiditis. Repetitive stress or chronic overuse can result in a stress fracture of the sesamoid bone which can be a cause of persistent pain. Sometimes a condition called osteonecrosis, caused by a lack of blood supply to the bone, can give rise to sesamoiditis. Frequent use of high heel shoes can aggravate the condition.
A dull, longstanding pain is the predominant symptom of sesamoiditis. Usually the pain is gradual in onset but in cases of fracture the onset of pain is sudden. Pain is aggravated by movement of the affected body part or any pressure over it. In some cases swelling and bruising may be present.
A thorough physical examination is essential for the diagnosis of sesamoiditis. Your physician will check for tenderness and aggravation of pain on movement. The examination helps evaluate the type and cause of the injury. X-rays may be ordered to confirm the diagnosis. In case an X-ray is inconclusive your physician may order a bone scan.
Usually the treatment of sesamoiditis is non-surgical. In very rare cases, surgery is considered when the non-surgical approach fails to provide any benefit.
The non-surgical treatment options include:
Immobilization: Take adequate rest and place the foot in a removable cast. Avoid activities which cause pain. Crutches may be used to avoid weight bearing on the affected bone.
Padding and strapping: A pad may be used to cushion the inflamed area. Strapping can be used to relieve the muscle tension around the inflammation.
Physical therapy: Some exercises such as range of motion exercises and strengthening exercises may be advised to improve the condition. Ultrasound therapy can also be helpful in relieving pain.
Orthotic devices: Some orthotic devices such as special shoes that cushion the injured area can relieve the pressure over the affected sesamoid.
Oral medications: Non-steroidal anti-inflammatory (NSAIDs) medications may be used for the reduction of pain and inflammation.
Steroid injection: Sometimes a steroid injection may be used to reduce the pain.
A recurrence of the sesamoiditis can be prevented by following a few simple measures which include:
- Use appropriate shoes with proper padding.
- Follow physical therapy for improving gait and strength.
- Avoid the use of high heel shoes and other activities associated with aggravation of pain.
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Houston Foot and Ankle Specialists
Physicians at Advanced Orthopedics and Sports medicine are trained in the treatment of most foot and ankle problems. They are trained in the treatment of complex foot problems, forefoot deformities (bunions, hammer toes, etc.), ankle injuries, fractures/dislocations, major and minor foot/ankle reconstructions, ankle replacements, minimally invasive surgery, arthroscopy, and non-operative management of foot and ankle problems, including treating the special populations, including diabetics and rheumatoid arthritis. In addition to common surgical options, advanced techniques include ankle arthroscopy, subtalar arthroscopy, deformity correction with internal or external fixation (Ilizarov/ring fixation) and ankle replacement.
Drs Elbaz and Brooks now perform Platelet-Rich Plasma (PRP) injections for the treatment of plantar fasciitis, shin splints, peroneal tendonitis, Achilles tendonitis or partial tears. PRP stimulates a more rapid healing of tendon, ligament, muscle and bone.
Contact us today to Schedule an Appointment or call us at 281-955-2650 to learn more about our Foot and Ankle Treatment options.
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What Our Patients Are Saying
Each procedure done by Dr. Patel has been an improvement. Very pleased.
Dr. Patel has been a great Doctor for me. When I was referred to after discussion we decided to do injections in my back. The first two did not work so did two more in a different section of my back. These injections worked great. I’m now able to sleep at night and the numbness in my foot is almost gone. The tingling in my foot & leg is gone and I am very happy about that. I am extremely happy that Dr. Patel is my Doctor. She has been a good listener when I tell her where I hurt and talks to me about what she feels should be done. The final decision is always mine.
On Nov. 22, 2017, I had a spinal injection in my lower back and it was an instant miracle in my life! For the first time in 4 intolerable months of pain, I was finally pain free, and I am now getting a second chance to live again! I am so grateful to Dr. Patel for my new life, and to God for guiding me to her! Thank you so very much Dr. Patel – you are God’s gift to me, thank you for being so awesome at what you do.
Dr. Patel is one of the best Doctors I have ever had. She is pretty good at her job. She makes it plain and simple. She is also very thoughtful. I was very glad to have met her. In other words she is pretty good.
The surgery done by Dr. S. Patel (Actually injections) & the mild medications she has prescribed has surely made my lower back -hip-leg less painful. I have complete confidence in her medical judgement & advice. She will administer second injection in June.
Dr. Patel is a very good Pain Management Doctor. She is one of my favorite doctors.
Dr. Patel has been great at my pain relief. She doesn’t force me to take any meds I don’t want, or injections. She will give me the injection I want when I need it. Great friendly Doctor.
Thank you for the opportunity to express how pleased I am with the excellent care of Stacy A. Bacon, M.D. I have confidence in her ability to care for me as she successfully partially replaced a broken hip 10 years ago, 2007. I also want to compliment Cheryl who set up the appointment. She represents Advanced Orthopaedics & Sports Medicine very well.
It’s been over 8 years since Dr. Bacon replaced by right ankle. I still can’t thank her enough for the years of pain free walking I have done since! And I’m still going strong! I had numerous breaks in my ankle due an auto accident, repaired/set by a different doctor, after multiple surgery’s, I was still limping, in great pain every day. Then I found Dr. Bacon, now, no more pain, NONE, and no more limping after this ankle replacement. I rave about her constantly and would recommend her to anyone who has a foot or ankle issue
I had been in so much pain with my back for years. It got so bad that I knew I had to do something. I went to Dr Mohr for help. I was so afraid to have spine surgery as I had heard so many horror stories. He and his staff were very informative. I was amazed at the new technology in spinal surgery. December 8, 2016 I had rods and pins put in my back. I am so happy I did now. I am healing really fast and the pain is going away as my body heals. Thank you Dr Mohr for you expertise and sensitive nature. You were understanding about my fear and helped assure me so I could receive the help I needed. You are an excellent Doctor.