It might be Sesamoiditis and it’s worth getting checked out.
It’s not uncommon to experience a sharp fairly focused pain under the head of the 1st metatarsal, or big toe joint. Usually slightly to the midline of the body versus the outside of the foot. There may be swelling, redness, heat or limitation in the range of motion of the joint.
What is a Sesamoid
The sesamoids are two small bones located in one of the tendons that run under your big toe joint. They behave as a fulcrum or pivot allowing the joint to flex and bend while baring weight. Without them, the tendon could get entrapped limiting motion. The medial sesamoid (the one closest to the midline of the body) is the most common one to cause pain.
Normal sesamoids are like a half pea, smooth, symmetrical and look on X-ray like two little eyeballs on a metatarsal head.
Sometimes they can get fractured, enlarged, or displaced laterally. Any of which can give rise to swelling and significant discomfort. Other times they may look perfectly normal but due to physical trauma from impact, increased activity, new footwear, poor foot function the tissue becomes inflamed.
In all cases, inflammation is a factor of pain. The first step is to stop making the condition worse. That could mean short-term :
- limit unnecessary activity
- avoid certain footwear (high heels)
- apply topical anti-inflammatories
- oral antiinflamitories
- elevate/ice the foot
- avoid barefoot weight baring
Then seek professional help, NOT ONLINE!
Imagining ( x-rays or ultrasound) will help get an accurate diagnosis of a fracture. Before during or after imagining then visit your Podiatrist or Chiropodist for a Who Done It Adventure. With a bit of a history taking, physical exam, review of your X-rays, review of a selection of your regular footwear, general physical and medical history, a cause and treatment options should be possible. Requesting general physical and medical information surprises some people, but the further we get from the core of the body the more we see manifestations of systemic illness. In this case for example we might be seeing manifestations of osteoporosis or peripheral vascular disease. Regardless, be patient, we`re here to help even if sometimes the direction of our examination takes unexpected turns.
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