Get Back On Your Feet – Pain-Free
Struggling with Sesamoiditis? Here’s What You Can Do
If you’re experiencing persistent pain beneath your big toe, you may be dealing with sesamoiditis—an often overlooked but painful foot condition. At Balance Foot & Ankle Specialist in Michigan, we understand how debilitating this can be. That’s why we’ve compiled the most effective treatment options to reduce inflammation, relieve pressure, and help you walk comfortably again.
Sesamoid Pain Treatment (Causes, Symptoms & Best Treatment)
Sesamoiditis & Sesamoid Pain can cause SEVERE big toe joint pain. We go over the 100% best treatment options for your big toe joint pain!
- Sesamoiditis is the inflammation of the two little bones under the big toe joint.
- This can cause pain during pushing off, running, and jumping.
- This can take months to get better if not treated properly!
Top 5 Big Toe Joint Causes Picture & Photo Gallery:
Look:
- A bunion is a pre-dislocation of the big toe joint.
- Big toe joint arthritis is also known as hallux rigidus and can form a very large toe joint spur.
- A turf toe is the hyperextension and bending of the big toe joint. This can cause ligament and tendon damage.
- Sesamoiditis of the big toe joint is the inflammation and possible fracture of the two bones underneath your big toe joint.
- Gout in the big toe joint is the buildup of the crystal substance called uric acid.
So, check out the big toe diseases by clicking on the photo gallery for descriptions!
Big Toe Joint, Hammer Toe & Bunionette Problems:
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Sesamoid Bone Pain Treatment Video
Sesamoid Bone Pain Causes

Causes of Big Toe Joint Pain
Bunion:
- A bunion is the beginning of the dislocation of the big toe joint.
- The official term is subluxation, this is when the first metatarsal phalangeal joint starts to come out of the joint.

- This usually means the big toe joint is starting to point towards the second toe, this forces the second toe to rise over the big toe if it gets bad enough.
- This can contribute to forming a second toe hammer toe, as well as making the second, third, fourth, and fifth toes spread towards the outside of the foot.
- You can also develop a bunion to your fifth toe, this is called a tailor’s bunion, or a tailor’s bunionette.
Turf Toe:
- A turf toe injury is the hyperextension of the first metatarsal phalangeal joint, also known as a big toe joint sprain.
- There are many tendons and ligaments and bones on the bottom of your big toe joint.
- If you strain the tendons and ligaments, these can take many weeks or many months to heal.
- If you ever watch professional football, or soccer, this is a very common sports injury when the big toe plants into the ground and all your body weight transfers over.

Sesamoiditis:
- There are two bones underneath your big toe joint called your sesamoids bones. These are the tibial sesamoid and the fibular sesamoid.
- If the big toe joint becomes disrupted, such as in a bunion these can become dislocated sesamoids.
- In sports such as basketball where there is a lot of pressure put on the big toe joint, this can lead to inflammation of the sesamoid bones. This is called the sesamoiditis.
- If your sesamoiditis gets really bad, it is also possible to get a broken sesamoid, or sesamoid fracture.
- It can be a good idea to see a podiatrist if you do have a broken or fractured sesamoid bone.

Big Toe Joint Arthritis (AKA Hallux Rigidus):
- Arthritis means that the cartilage is missing from your joint, this then prevents normal joint motion. Eventually as the damage keeps getting worse, the bone starts to crack, cause severe pain and eventually develop bone spurs and uneven bone at the site.

- In your big toe joint when you start to lose some motion, this is called hallux limitus. Eventually this starts to lose complete motion and this is now called hallux rigidus. This means that your big toe joint is rigid and unable to move.
- There are four stages to hallux rigidus,progressing from no arthritis to complete fused arthritis.
- Hallux rigidus and big toe joint arthritis essentially mean the same thing.
- This is a very common problem that we see especially in people who are on their feet all day, or have broken their toe in the past.

Flat Foot:
- Flat feet can be caused by many different things, and flat feet result in many different problems.
- The more your foot flattens, the more abnormal pressure is put onto your big toe joint. This can lead to abnormal pressure causing a dislocation also known as a bunion, or jamming of the cartilage which can lead to big toe joint arthritis or hallux rigidus.
- Flat fee are very complicated topic, as you can have a bunion in a high arched foot as well, but generally it is the act of over pronation that causes your big toe joint to receive pressure and become agitated.
- Controlling flat fee with more support has more pros than cons for sure.

Sesamoiditis Causes:
- Sesamoiditis is most commonly caused by too much pressure underneath the big toe joint.
- There are two small bones underneath the big toe joint called the tibial and the fibular sesamoid bones.
- I see this most commonly during people playing basketball or people pushing off with their big toe joints.
- It is also prevalent in people with a very high arched foot
Symptoms:
- The symptoms of sesamoiditis are usually sore, aching pain underneath the big toe joint.
- This can also cause numbness, burning, and tingling.
- This can also cause big toe joint soreness and difficulty bending the big toe joint.
Bruised sesamoid:
- A bruised sesamoid is very similar to sesamoiditis.
- There can be a fractured sesamoid from a big bump or injury, but generally, it is just bruised.
- For purposes of this discussion, we will consider a bruised sesamoid the same as sesamoiditis.
- This is the inflammation of this fibular and tibial sesamoid.

Fractured sesamoiditis or fractured sesamoid:
- If you fall from a large height or really bump your big toe joint, the sesamoid bone may be broken.
- The only way to really know this for sure is to get an x-ray taken.
- It is also possible to have something called the bipartite sesamoid. This means that it never really fused.
- A bipartite sesamoid is very common.

There are two types of sesamoid:
- The tibial sesamoid is towards the medial side of your body or the inside of your foot.
- The fibular sesamoid is the one towards your fist toe or the outside of your foot.
- Generally, the tibial sesamoid is the one that is causing the pain during sesamoiditis foot pain.
Sesamoiditis Pain treatment:
- There are options to use the sesamoiditis pad to take pressure off your hallux sesamoid.
- What we prefer is to use the best possible sesamoiditis orthotics.
- We link our favorite sesamoiditis orthotics below.
- These will provide you sesamoid pain relief.








Big Toe Joint Home Treatment Infographic

Big Toe Joint Injury or Surgery Treatment:
- If you think you might have a severe turf toe, a severe tear or sprain, a broken big toe joint or broken big toe, or you have just had surgery: this guide may be able to help you!
- Just make sure to check with your podiatrist because a severe injury will require imaging, biomechanical evaluation, and a good discussion to prevent anything from going more wrong.
- For surgery, purposes make sure to discuss with your podiatrist To see what is recommended, as every surgery is unique, and there are pros and cons to all treatment methods.
Big Toe Joint Fracture, Sprain, or Surgery Products:
- If you have a traumatic injury such as a broken bone or ligament tear, these products may be able to help you.
- The best way to do this is, of course, to see your podiatrist and get evaluated with an x-ray, ultrasound, and potentially even an MRI or CT scan.
- If you cannot do so, it may benefit you to be in a cast, fractured boot, or even keep the weight off of it with a rolling knee scooter or other protective devices.
- We as podiatrists frequently take patients off work for a very long period of time when they suffer a traumatic injury. Unfortunately, there is no other way around us in labor jobs.
- If you have a sit-down job, there are ways to get people back to work quicker, but this can be impossible otherwise.
- Just remember these injuries can take a very long time, specifically 2 to 3 months or more, to come back from if you’re going to be on your feet all day. There is a long recovery time and healing time in most cases.
Big Toe Joint Injury & Surgery Immobilization:
- There are pros and cons to using a boot to treat your big toe joint injury. If you are immobilized too long, the cons are that you will gradually become stiff and overworked to your other leg.
- The Pros are that your injured heel will hopefully have a chance to heal gradually!
- Our favorite fracture boots and their supplies:








Big Toe Arthritis and Hallux Rigidus:
- One of the best treatment options for a stiff big toe is a stiff orthotic.
- The big toe can become arthritic, and what causes the pain is the bone grinding on a joint that cannot move.
- Getting a rigid carbon insole can make a huge difference in preventing the bend of the big toe joint.
- Out of the big toe joint products in the next table, the carbon insole is worth looking at for relieving the big toe joint bed.
- A good over-the-counter orthotic can provide a similar result, and we would otherwise prefer those.








Offloading and Scooter Treatment:
- If you cannot use your foot, it needs to be immobilized: we have found success with offloading the scooters in these products.
- Crutches can be difficult long term, whereas scooters can really help you get around and to work if you have a sit-down job in this been okay-ed with your podiatrist.
- These are our favorite knee scooters and walking devices:








Best Big Toe Joint Products:
- There are usually two phases to treating big toe joint pain
- The two phases of treatment include controlling the acute inflammation with protection and correcting the biomechanics, which led to the problem in the first place.
- If the tendons, joints, and ligaments are inflamed, they are almost frozen in place and cannot function properly.
- Inflammation can mean damage as well, in this most likely needs to be protected as the big toe joint heavily relies upon the weight-bearing joint. So consider discussing with your podiatrist the need for and offloading surgical shoes or boots.
- Once the inflammation is decreased, we need to correct the biomechanical causes to ensure that they can never become overworked and inflamed again!
- The key with an injury or surgery is to keep it protected initially, and when the bone and tendon heels, to get moving before stiffness can set in.
Best Bunion Specific Products:
- There are no perfect bunion treatment products.
- Most people end up disappointed after spending a lot of money on bunion pads, bunion gel pads, expensive bunion correctors, and bunion splints!
- The truth is a bunion is a biomechanical injury. The foot is flattening out, and the ankle is flattening out, causing the pain.
- Having a gel pad on the big toe has very little chance of fixing the deformity, although it can stop the rubbing and relieve a lot of the pain.
- This is why people sometimes wear splints and correctors. It holds the toe straighter so that the tissue and were’s and have left pain.












Big Toe Joint Inflammation Control:
Massage & Ice Products:
- Ice is an excellent option that can be safe for almost everyone.
- There is some debate about whether icing is worth doing, but this can help limit the need for medications and keep your options open for chronic pain.
- This works great for your arch, less for the ball of the foot.
- The more muscle and ligament tissue there is, the better ice will work there.






Menthol Based Gels:
- Biofreeze is one of our favorites.
- This can work well as a cream or gel option for your big toe joint pain.
- These gels have been studied to work 2x as long as ice.
- This works great for the ball of the foot.
- This can be very effective for the bottom of the heel and Achilles tendon sore regions.








Massage Sticks:
- These can work great for loosening your muscles.
- This is not to be used directly onto your foot but to help take pressure off the foot’s front.
- This allows less tightness and pressure on the ball of your foot.
- This is very effective for the arch, the gastrocnemius, calf muscle, and the hamstring and thigh muscles.
- This also works very well for the gluteus muscles if you are having butt cheek or hip pain.






Remove the Big Toe Joint Pressure:
- The key is to prevent future pain and to keep pressure off of the big toe joint.
- This means keeping you active while keeping stress off of your big toe joint. This will prevent future bunions, sesamoiditis, turf toe, and even big toe joint arthritis!
- If you can get rid of the pain and swelling, this will let you start walking normally.
- If you can walk normally, the vast majority of your pain should gradually start to go away.
- The best way to ensure that your big toe joint, hammertoes, and foot and ankle ligaments are not overworked is to support them.
- The best way to support them is to use great orthotics and great shoes.
- Some people may also need to rely on supportive ankle braces and other supportive modalities.
Best Big Toe Joint & Flat Foot Shoes:
- Getting a great supportive pair of shoes will make sure that there is no further pressure onto the ball of your foot and the big toe joint region.
- This is especially important if you have plantar fasciitis, heel spur pain, or Achilles tendonitis.
- Consider shoes combined with a good supportive orthotic for the best pain relief!
- We have found shoes and orthotics to be one of the most effective ways to reduce bunion and hammertoe pain.
- The following link will show you what our favorites are.
Best Big Toe Joint & Flat Foot Orthotics:
- These are our recommended orthotics for offloading the big toe joint.
- Custom orthotics can work very well, but they should not be the first line of treatment. Custom orthotics can cost a lot of money, over the counter orthotics can be a great introduction to foot control and prevent pronation.
- There are different types of orthotics for different types of shoes.
- Women’s shoes usually need a less bulky orthotic but allow for less correction of your big toe joint and ball of the foot pain.
- A full-length orthotic requires a running shoe, boot, or comfortable walking/dress shoe.
- We recommend doing everything you can to get a good supportive shoe that can fit a full-length orthotic. This will get you the best results for your bunion, hammertoes, and bunionette.
- This is the best way to maximize your orthotics for great results.
Click this link for the best podiatrist recommended orthotics!
Best Full-Length Orthotics:
- These will only work in wider shoes or a good supportive running shoe.
- This will not work in sandals, flats, or most women’s dress shoes.








Best Dress Shoe Orthotics:
- These are a great choice for dress orthotics.






Best 3/4 Length Orthotics:
- These are great options for women’s dress shoes and thinner shoes.
- These are not the most supportive pair of orthotics.


Get A Great Dynamic Stretch:
- The goal of getting a great stretch is to improve your ankle flexibility and prevent ball of the foot pain and big toe joint pressure.
- It is possible to stretch on your own, but these products can also really help!
- This will take pressure off of the ball of your foot.
- We personally prefer this method of stretching.








Get A Great Static Stretch:
- These devices are great for stretching while you are resting.
- This will also help take pressure off of the ball of your foot.
- This works great for plantar fasciitis but can also make your ankle more flexible in removing pressure from the ball of your foot!
- It can be used while watching TV or at night time.






Big Toe Joint, Hammer Toe & Bunionette Problems:
Sesamoiditis Pain Treatment: Frequently Asked Questions
Rest, ice application, and wearing cushioned shoes can quickly reduce inflammation and pressure on the sesamoid bones.
Yes. Most cases respond well to non-surgical treatments like orthotics, physical therapy, and anti-inflammatory medications.
Mild cases may improve in a few weeks, while more severe cases can take several months of consistent care and activity modification.
Limiting walking—especially barefoot or on hard surfaces—can significantly help recovery. Using crutches or protective padding may be advised in acute phases.
If pain persists for more than a week or worsens despite home care, it’s best to consult a foot and ankle specialist for a personalized treatment plan.