A nagging ache under the ball of your big toe with every step? That is your sesamoid bone speaking up — we know how to listen.
You are in the right place. Dr. Tom Biernacki, DPM, FACFAS — board-certified foot & ankle surgeon with 3,000+ surgeries — explains exactly what sesamoiditis and big toe pain means and what works. Call (810) 206-1402 for same-week appointment at Howell or Bloomfield Township.
Quick answer: Treatment for sesamoiditis big toe pain treatment 2 follows a stepwise approach: 1) conservative care first (rest, ice, supportive footwear, OTC anti-inflammatories), 2) physical therapy and targeted exercises, 3) in-office treatments (injections, custom orthotics) if conservative fails at 4-6 weeks, 4) surgery for refractory cases. Most patients resolve at step 1 or 2. Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
Quick Answer
Sesamoiditis: Pain Under the Big Toe Joint — Causes &# relates to toe deformity — typically caused by imbalanced muscles + footwear. Most patients improve in depends on severity with conservative care. Same-week appointments in Howell + Bloomfield Township: (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Insurance Accepted
BCBS · Medicare · Aetna · Cigna · United Healthcare · HAP · Priority Health · Humana · View All →
Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Township Office
43494 Woodward Ave, #208
Bloomfield Township, MI 48302
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Your Board-Certified Podiatrists
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Same-week appointments available at both locations.
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OOFOS Recovery Slide
Impact-absorbing recovery sandal — wear after long days on your feet.
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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 Township 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 Township
Differential Diagnosis: What Else Could It Be?
Not every case of sesamoiditis is straightforward. In our clinic we routinely rule out three look-alike conditions before confirming the diagnosis. If your symptoms don’t match the classic presentation, one of these may explain the pain — which is why physical exam matters more than self-diagnosis.
| Condition | How It Differs |
|---|---|
| Sesamoid stress fracture | Acute or gradually worsening sharp pain, tender directly over one sesamoid, positive findings on MRI. |
| Hallux rigidus | Stiff, painful big toe joint with limited dorsiflexion — pain is AT the joint, not UNDER the ball. |
| Turf toe (plantar plate injury) | Acute hyperextension mechanism, diffuse swelling of the 1st MTP, positive 1st MTP drawer test. |
Red Flags — When to See a Podiatrist Now
Seek same-day evaluation at Balance Foot & Ankle if you notice any of the following:
- Sudden sharp onset (possible fracture)
- Bruising or swelling under the big toe
- Pain at rest or at night
- Inability to push off during gait
Call (810) 206-1402 or request an appointment. Our Howell and Bloomfield Township offices reserve same-day slots for urgent foot and ankle issues.
In Our Clinic: What We See
Clinical perspective from Dr. Tom Biernacki, DPM — Balance Foot & Ankle, Howell & Bloomfield Township, MI:
In our Balance Foot & Ankle clinic, sesamoiditis patients are usually dancers, runners, or women who have spent significant time in heels. They describe pain directly UNDER the big toe joint — not at the joint (that’s hallux rigidus) — which worsens with push-off. On exam we palpate each sesamoid separately (tibial and fibular) and assess for sensitivity. We always get X-rays to look for sesamoid fracture or bipartite sesamoid (a normal variant). Treatment uses a dancer’s pad to offload the sesamoid, stiff-soled footwear to reduce push-off stress, and activity modification.
Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Same-week appointments in Howell + Bloomfield Township. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Book Today — Same-Week Appointments Available
Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Township, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your big toe and joint condition, our podiatry team at Balance Foot & Ankle can help with same-week evaluations and advanced in-office care.
Same-week appointments available. (810) 206-1402
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How long does treatment take to work?
Most patients see improvement in 4-8 weeks with consistent conservative care. Persistent symptoms after 8 weeks need imaging and escalation.
When is surgery needed?
Surgery is reserved for cases that fail 3-6 months of conservative care, structural deformities, or fractures requiring stabilization.
Is this covered by insurance?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Custom orthotics often require diabetic or post-surgical justification.
Ready to feel better?
Same-week appointments available in Howell and Bloomfield Township, Michigan.
Book Your VisitReady to fix this for good?
Reading goes only so far. The fastest path to relief is a 30-minute office visit with Dr. Biernacki — same-week, Howell or Bloomfield Township. Call (810) 206-1402 or use our online booking.
Ready for Expert Care?
Same-week appointments in Howell & Bloomfield Township, MI.
4.9★ | 1,123 Reviews | 3,000+ Surgeries
Or call: (810) 206-1402
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.