Sesamoiditis

Sesamoiditis is inflammation of two small bones beneath the big toe joint, causing pain in the ball of the foot that can make walking, running or standing uncomfortable. This condition often develops gradually from repeated pressure on the forefoot. Most people improve with nonsurgical care and can return to their normal activities.

Find a Specialist

Find a location

Anatomy of the ankle and foot, showing ligaments, tendons, and bones, labeled for clarity.

Anatomy of the big toe joint

The sesamoid bones sit within tendons under the ball of your foot, just behind your big toe. They act like small pulleys, helping tendons move smoothly while distributing your body weight across the front of the foot with every step.

Because this area absorbs so much pressure during walking and running, it's especially vulnerable to stress. Repetitive impact or sudden injury can irritate the sesamoid bones, leading to the pain and swelling associated with sesamoiditis.

Overview

Symptoms

Sesamoiditis symptoms tend to center on the ball of the foot, just behind the big toe. You may notice:

Pain beneath the ball of the foot, just behind the big toe
Swelling or tenderness in that area
Increased pain with walking, running or certain shoes
Discomfort when bending or straightening the big toe
Difficulty putting weight on the front of the foot

Symptoms may develop gradually over time or begin suddenly after increased activity or an injury.

Causes

Sesamoiditis is linked to repeated pressure on the forefoot. Contributing factors may include:

Running, dancing or jumping sports
Shoes with thin soles or high heels
Structural differences such as high arches
A sudden increase in activity
Direct impact to the ball of the foot

Risk factors

Certain factors can make you more likely to develop sesamoiditis, though having one or more of these does not mean you'll experience this condition:

Participating in high-impact sports like running, dancing or jumping
Wearing shoes with thin soles or high heels
Having high arches or other structural foot differences
Quickly increasing your training intensity or activity level
A history of direct trauma to the ball of the foot

Knowing your personal risk factors can help your care team guide your footwear choices and activity level.

Diagnosis

Your Novant Health foot and ankle specialist will review your symptoms, activity level and footwear, then examine your foot to pinpoint tenderness and check your range of motion. To confirm sesamoiditis and rule out other conditions such as fractures or arthritis, your care team may recommend imaging tests like X-rays, MRI or bone scans to evaluate inflammation or injury to the sesamoid bones and surrounding tissues.

View treatment options

We offer leading-edge treatments for most foot and ankle conditions, treating many with medications, bracing and injections.

Explore treatments

Take the next step

Our board-certified specialists are here to help you heal. They can often diagnose the problem in one visit and get you started with a personalized treatment plan. We offer a wide variety of treatment options.