What is sesamoiditis?

I don’t have a bunion. Why do I have pain at the base of my big toe joint?

Pain at the big toe joint is often attributed to a bunion, which is a common foot problem especially affecting the medial side of joint. But what about the base of the joint? It is where the sesamoid bone located. Each foot has two sesamoid bones at the base of the front of first metatarsal. They are surrounded by the plantar tendons and act as pulleys to promote normal flexion of the big toe. If the foot is misaligned, and if there is a lot of forefoot landing, the sesamoid bones can be susceptible to inflammation.


The main cause of sesamoiditis is compression or displacement of the sesamoid bones

  • Sudden increase in the amount of exercise
  • Hallux valgus (Bunions)
  • People who need to land on their forefoot are at risk (e.g. sprinters, football or rugby players, etc.)
  • Abnormal foot biomechanics (e.g. flat feet, over-pronated feet, high arched, knee valgus, etc.) can cause a change in the direction of motion of the flexor hallucis longus muscle, leading to unnecessary friction between the sesamoid bones and the inter-sesamoid ridge, causing inflammation


  • Feeling stretched or pain at the base of big toe during walking or standing
  • The affected area may be red, swollen or hot


  1. Custom-made prescription foot orthoses: If there is foot malalignment, you should consult pedorthist for a detail foot assessment and order a pair of custom-made prescription foot orthoses to correct the biomechanics.
  2. Dancer Pad: Insoles with dancer pad can be used to reduce the pressure on the sesamoid bones.
  3. Cold pad : Apply to the affected area when redness is present
  4. Self Care : Avoid sudden increase in the level of physical activity. Warm up before exercise to reduce the risk of injury.
  5. Medical Advice : Seek medical advice on treatment plan of sesamoiditis.