Each person has two sesamoid bones in each foot, located in the ball of a person’s foot, underneath their big toe joint. These two pea-sized bones are embedded in a specific tendon and help act as a pulley for the tissue when you flex or curl you big toe. They also help to handle stress and protect the big toe joint with every step you take. Like all bones in the foot, they are prone to irritation, inflammation and fractures.
The two most common conditions that affect your sesamoid bones are sesamoiditis and a sesamoid fracture. We take a closer look at both conditions in today’s blog.
Sesamoiditis Vs. Sesamoid Fracture
It can be very difficult to distinguish between inflammatory sesamoiditis and a sesamoid fracture because both injuries oftentimes present with similar symptoms. For example, both conditions are oftentimes categorized by:
- A sharp or dull pain in the ball of the foot, underneath the big toe joint.
- Increased discomfort with big toe flexing or curling.
- Increased discomfort when pressure is applied to the area.
A sesamoid fracture will tend to produce more intense symptoms, but since it’s unlikely that you’ve experienced both conditions, it may be difficult to know which condition you are dealing with based on symptoms alone. Diagnostic testing is the most obvious answer, but you may also be able to get an idea of which one you’re dealing with by reviewing the mechanism of injury. The pain of inflammatory sesamoiditis is typically caused by overuse, and oftentimes has a more gradual onset. While a sesamoid fracture can also develop as a result of overuse, these fractures are more often caused by an intense moment of stress on the area. Because of this, a sesamoid fracture usually has a sudden onset after trauma to the foot.
Diagnosing And Treating Each Condition
Fortunately, it’s not a big deal if you’re unsure which sesamoid-related condition you’re dealing with for a few reasons. For starters, your foot specialist has all the tools to provide an accurate diagnosis, and an X-ray or MRI will likely be ordered after a physical exam of your foot. Also, both conditions typically have a similar treatment regimen. You may be more likely to need surgery if you have a sesamoid fracture, but both conditions are highly likely to resolve with the help of conservative care, so that’s the path your provider will attempt first.
Treatment will be focused on taking stress off the area so that the inflammation or fracture has time to resolve. This is most commonly done by adjusting your footwear. You’ll likely be put in a walking boot, shoes with added cushioning or fitted for custom orthotics to help provide more protection to the big toe joint area. You may also be told to take some over-the-counter anti-inflammatory medications and be asked to avoid certain physical activities for a few weeks.
In most instances, both sesamoiditis and a sesamoid fracture tend to heal well after a number of weeks of following the above treatments. Sesamoiditis tends to resolve quicker, with a recovery timeline between 3-6 weeks, while a sesamoid fracture usually needs 4-8 weeks, but again both of these timelines can vary, so stick with the plan put forth by your foot specialist. They can also walk you through the surgical procedure should it come to this, but surgery is avoided if at all possible, so expect a healthy dose of conservative care to do the trick.
For more information about either condition, or to talk to a foot specialist about pain you’ve been experiencing, reach out to Dr. Silverman and the team at Silverman Ankle & Foot today at (952) 224-8500.
