Sesamoid pain rarely needs surgery — the right offloading and rest protocol clears most cases.
You are in the right place. Dr. Tom Biernacki, DPM, FACFAS — board-certified foot & ankle surgeon with 3,000+ surgeries — explains exactly what sesamoid bone pain treatment means and what works. Call (810) 206-1402 for same-day appointment at Howell or Bloomfield Hills.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
The most important clinical decision with Sesamoid Bone Pain Treatment Michigan isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Quick Answer
Sesamoid Bone Pain & Sesamoiditis Treatment Michigan relates to foot pain — typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
Quick Answer
Most foot and ankle problems respond to conservative care — proper footwear, supportive inserts, activity modification, and targeted stretching — within 4-8 weeks. Persistent pain beyond that window, or any symptom that prevents walking, warrants a podiatric evaluation to rule out fracture, tendon tear, or systemic cause.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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See Dr. Tom’s Top Shoe Picks →The sesamoid bones are two small, pea-sized bones embedded in the flexor hallucis brevis tendon beneath the first metatarsophalangeal joint (big toe joint). They function like the kneecap for the foot — acting as a pulley system to increase the mechanical advantage of the tendons moving the big toe. When these bones become inflamed, fractured, or lose their blood supply, the resulting pain can be debilitating. At Balance Foot & Ankle, Dr. Tom Biernacki provides expert sesamoid evaluation and treatment for Michigan patients.
What Causes Sesamoid Pain?
Sesamoiditis (sesamoid inflammation) is the most common sesamoid problem. Repetitive stress on the sesamoids — from running, dancing, high heels, and push-off activities — inflames the surrounding soft tissue. Pain is localized to the plantar surface of the big toe joint, worsened with push-off, and tender to direct pressure on the bone.
Sesamoid fracture — Acute fracture from a fall, jump, or direct blow; or stress fracture from repetitive loading. The fibular (lateral) sesamoid is more commonly fractured than the tibial (medial) sesamoid. Diagnosing true fracture versus a bipartite sesamoid (a normal variant where the bone forms in two pieces) requires comparison X-rays of both feet, and MRI or bone scan for definitive diagnosis.
Avascular necrosis (AVN) — Loss of blood supply to the sesamoid causes bone death. AVN is associated with prolonged steroid use, rheumatoid arthritis, and sickle cell disease. MRI is essential for diagnosis. Advanced AVN typically requires sesamoidectomy (surgical removal).
Who Gets Sesamoiditis?
Sesamoiditis is a classic overuse injury in dancers (especially ballet dancers), runners, basketball players, and anyone who spends significant time on the balls of their feet. High-arched feet (cavus foot) concentrate pressure on the sesamoids and increase injury risk. High-heeled shoes load the sesamoids with every step and frequently cause or aggravate sesamoiditis.
Non-Surgical Sesamoiditis Treatment
Dancer’s pad — A horseshoe-shaped felt or foam pad that offloads the sesamoid region is the most important initial treatment. By surrounding (not covering) the painful sesamoid, pressure is redirected away from the bone with every step. Properly fitted dancer’s pads can resolve mild-to-moderate sesamoiditis over 4–8 weeks.
Custom orthotics with sesamoid offloading — A full-length custom orthotic incorporating sesamoid offloading provides consistent pressure relief through all types of footwear. Dr. Biernacki incorporates a precisely positioned dancer’s pad cutout into the orthotic based on a 3D scan of your foot.
Activity modification — Eliminate push-off activities (running, jumping, stair climbing) that load the sesamoids while healing. Low-impact cross-training (swimming, cycling, elliptical) maintains fitness without sesamoid stress.
Cortisone injection — An ultrasound-guided cortisone injection into the sesamoid bursa reduces inflammation rapidly. Dr. Biernacki uses ultrasound guidance to confirm injection accuracy and avoid injecting directly into the bone surface.
Immobilization — Severe sesamoiditis or stress fractures may require a walking boot or short leg cast for 4–6 weeks to allow bone healing without mechanical stress.
Sesamoidectomy Surgery
When conservative care fails after 3–6 months, or for avascular necrosis, surgical removal of the sesamoid (sesamoidectomy) is curative. Dr. Biernacki removes only the affected sesamoid through a small plantar or dorsal incision, preserving the intact sesamoid and the associated tendons. Recovery involves a surgical shoe for 2–4 weeks; most patients return to full activity in 6–8 weeks. Results are excellent in well-selected patients.
Sesamoid Evaluation in Michigan
Sesamoid pain is frequently misdiagnosed as plantar fasciitis or general forefoot pain. Accurate diagnosis from an experienced podiatrist is essential. Call Balance Foot & Ankle at (734) 479-6200 for a sesamoid evaluation at any of our southeast Michigan offices.
More Podiatrist-Recommended Foot Health Essentials
Hoka Clifton 10
Max-cushion everyday shoe — podiatrist favorite for walking and running.
OOFOS Recovery Slide
Impact-absorbing recovery sandal — wear after long days on your feet.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Hills clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Frequently Asked Questions
How long does sesamoiditis take to heal?
Mild sesamoiditis with strict offloading and activity modification can improve significantly in 4–8 weeks. Moderate to severe sesamoiditis, especially with a stress fracture, can take 3–6 months of conservative care. Compliance with offloading is the most important predictor of recovery speed — continuing to run or dance through sesamoid pain dramatically extends recovery time.
Can you walk after sesamoidectomy surgery?
Yes. Most patients walk in a surgical shoe immediately after sesamoidectomy. Return to regular shoes takes 2–4 weeks. Return to sports and dance typically occurs at 6–10 weeks. Overall recovery is much faster than most patients expect, and pain relief is immediate after surgery.
What is a bipartite sesamoid and is it the same as a fracture?
A bipartite sesamoid is a normal anatomical variant where the sesamoid bone forms from two separate ossification centers that never fully fuse — present in approximately 10% of the population, usually bilaterally. It is not a fracture. Distinguishing it from an acute fracture on X-ray can be difficult — comparison views of the opposite foot and MRI are the most reliable methods. Bipartite sesamoids can become symptomatic when they are subjected to excessive stress, and treatment is the same as sesamoiditis.
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
Medically Reviewed by: Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Hills Office
43494 Woodward Ave, #208
Bloomfield Hills, MI 48302
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Same-week appointments available at both locations.
Book Your AppointmentMost Common Mistake We See
The most common mistake we see is: Waiting too long before seeking care. Fix: any foot pain lasting more than 4 weeks, or any sudden severe symptom, deserves a professional evaluation rather than more rest.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Unable to bear weight
- Severe swelling with skin colour change
- Fever with foot pain (possible infection)
- Diabetes plus any new foot symptom
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
More Sesamoiditis Guides from Dr. Tom
Need treatment? Learn about in-office sesamoiditis treatment at Balance Foot & Ankle, or call (810) 206-1402 for same-day appointments.
