What are the Best Treatments for Sesamoiditis with Seattle Podiatrist Dr Larry Huppin
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- Опубликовано: 4 сен 2024
- www.footankle.c... Seattle Podiatrist Larry Huppin discusses the treatments for sesamoiditis, including hints on how to treat it yourself and when to seek professional care.
Sesamoiditis is the inflammation of the small bones under the big toe joints and can lead to pain in the ball of the foot. It can usually be treated conservatively but pain in this area can also be caused by fractures of the sesamoids, so if you are not better in a couple weeks be sure to see a podiatrist. Sesamoiditis tends to be more common in people with high arches or bunions. Also we often see it in people who participate in jumping sports such as volleyball and basketball.
If you are in the Seattle area appointments can be made from our website at www.footankle.com/
Dr. Larry Huppin completed an exclusive fellowship in orthotics and biomechanics and has since become a leading national authority on the subject. He has practiced podiatric medicine in Seattle for over 20 years and has a special interest in helping patients achieve complete relief of any foot problem without resorting to surgery.
We are located at:
Foot & Ankle Center of Washington
600 Broadway, Suite 220
Seattle, WA 98122
206-344-3808
Custom orthotics provided relief relatively quickly for me. Now I wear them occasionally. Taping toes also helped.
How is it now
I had this for a year and I was in a boot for 4 months. I got mris and customized insoles and the pain went away. Now (a year later) the pain is back😩😩
I think this is actually what I have, they told me it was gout 2 years ago but i just had the synovial fluid examined this week and no crystals! I actually might be able to solve my pain!
Just got diagnosed with this from a DPM. Was feeling toe pain for the last week and it came out of no where. He gave me an anti-inflammatory and a pad for under my foot insert to relieve pressure. I hope this helps. This condition sucks.
The pages below provide detailed information on treatment of sesamoid pain, including home treatment options. If you start with home treatment, give it about 3 weeks and if you are not better see a foot specialist.
Sesamoid Pain Causes and Treatments:
www.footankle.com/pain-balls-feet/sesamoiditis/
Home Treatments for Sesamoid Pain:
www.footankle.com/self-care/ball-feet-pain-home-treatment/
Believe I've been struggling with this for about 18 months, but was misdiagnosed as everything from gout to a fracture. First visit to a chiropractor yesterday and during the treatment in this area he said he felt a pop. A few hours later, the entire area of the outer sesamoid was bruised, but pain subsided quite a bit. Today, bruise is gone and pain is 90% gone. Any thoughts on this? Thanks, Doc!
+Thomas Byrne Well, that's unusual. Just as a guess you may have had something called a "joint mouse". It is a little bit of bone or cartilage that has broken off and is floating in the joint. It may have been jamming the joint and then broke loose, thus reducing your pain. But that is truly just a guess. Glad you feel better!
I'm scared. What if I have this? My ball of foot has been hurting for 2-3 days already...
Here is some more info on sesamoiditis including home treatment options: www.footankle.com/pain-balls-feet/sesamoiditis/
You do such a great job on your videos! Thanks for the great information!
You are so welcome!
I’ve been trying to figure out what this was for like a year & a half. When I went to the doctor a few months into it, they just said well it’s not sprained or broken so idk...but now it’s been so long that i’m afraid i won’t be able to just use home remedies
Same it’s been 2 years now for me and they told it’s not broken or strained. I still have it. The pain comes and goes. Can you please tell me how did it go for you and how it managed to overcome it
Can this be completely treated? So far I have yet to find stories of diagnosed people making a full recovery
+timm2069 Absolutely it can be completely treated. But sesamoid problems take a long time to heal because there is so much force on the sesamoids. It usually requires a number of weeks of immobilization in a walking boot followed by immediately moving into a custom orthotic that is designed to aggressively reduce pressure on the sesamoids. I then have my patients not go barefoot at all for 3 - 6 months. You can find info on that type of orthotic here: www.footankle.com/orthotics/condition/ball-of-foot-pain/
This started after I had the Cartiva implant, which ended up failing at 3 weeks. I noticed the pain at 2 to 3 weeks. I understand that this is common with the Cartiva. I never had this before. Can you explain to me how this happens after the Cartiva? I went in at 4 weeks and my podiatrist did the Arthosurface Hempi Implant. The results are great! I have the pain now from sesemoditis after Cartiva.
I was just diagnosed with this
Brittnee Lemons Follow the instructions in the video or on this page: www.footankle.com/self-care/ball-feet-pain-home-treatment/. Try this for two weeks. If not better, see a podiatrist in your area. Good luck!
When sesamoid bone fracture how much time to develop?
I first got sesamoiditis about a year and a half ago. Lasted about a week, few months go by and it returns and like last time lasted about a week. 2017 I had no problems until mid December. Lasted about a week. Now a month later it has returned. What does it mean when it goes away and returns?
Usually that you have yet to take enough pressure off of the sesamoids. See this page for detailed information: www.footankle.com/pain-balls-feet/sesamoiditis/
Matthew Bailey I have avascular necrosis in my foot from this problem. Should i get the bone removed? I read a form of how many people got the bone removed and some people said it worked and they were able to return to physical activity and some people said they were never the same after surgery so that’s why am asking
Hi, im currently bed ridden for past week with sesamoiditis flare up.. Pain is severe. Can anyone please advise me what is best NSAID for sesamoiditis healing? Im using Prednisone 20 mg every morning and 3x daily 400mg ibuprofen or 3x dexketoprofen 25mg. I believe it is going away slowly now after 7 days. But I believe I will still be needing another 10 days to start mooving properly. Thns everyone.
I'm struggling with sesamoiditis since March 2015 (pain for almost 2 years). Tried first gel pads, arch support, quit playing basketball 8 months ago, quit lifting weights 6 months ago, had cortisol shot in right foot 4 months ago, had prolo shot 1 month ago, right now using fortex analgesic spray, NOTHING HELPS!!! Xray from September 2015 and Xray from October 2016 are showing everything normal, no fracture, no thinned out muscle tissue as it feels. I'm not even sure if my foot specialist knows what else to do about it?? Any advice helps 🙏
Sesamoids take a huge amount of force with every step and can be hard to heal sometimes. I can't comment on your specific situation but I will tell you that to heal sesamoiditis I often must put patients in a walking boot for 6 - 8 weeks and build up the inside of the boot so that the sesamoid bears no weight at all. After that I move them into a stable shoe with a very, very tight fitting custom orthotic to maximally transfer pressure off of the sesamoid. If it is still not better I would probably want to get an MRI. You can read more here: www.footankle.com/pain-balls-feet/sesamoiditis/
+Foot & Ankle Center of Washington
my husband's sesamoid is sharp pain, sometimes burning and only hurt when pressure is on the sesamoid by finger touch, when walking he does not feel pain. Do you have any advice on what this means for him. Thank you for your time
Same im 6 months in its so miserable
I'm in a boot right now. Can you do a video on how you put a build up inside of the boot so that the sesamoid bears no weight?
I'm not sure if I have this or not! I did some research when the pain was bad and it seemed like I might be metatarsalgia or Morton's Neuroma. The doctor did an x-ray but it was normal according to him. The pain has lessened thankfully but it's still sore. Would the x-ray have shown sesamoiditis??
Sesamoiditis is simply an inflammation of the sesamoid and would not show up on x-ray. If you saw a regular doctor, you should see a foot specialist. A good one will be able to figure this out very quickly. More information here: www.footankle.com/pain-balls-feet/sesamoiditis/
my husband sesamoid only bothers him when I touch, rub basically put hand pressure on it. he said he does not hurt when he walks, do you have any advice on what this means for him, and any suggestions u may have to assist removing this problem. Thank you for your time.
I have it for 2 years, I've used special soles, ulstrasound treatment, electricity, everything and nothing works :(
+Peppy_23 This article is a good review of the current thinking on sesamoid injuries and treatment. www.podiatrytoday.com/comprehensive-guide-reviving-sick-sesamoid You need to find a doctor in your area who is very experienced with treating these. Usually a podiatrist specializing in sports medicine is a good choice.
Thank you! I'm desperate and i don`t want surgery :(
Nope! I',m petite and normal weight my Bmi it's 27
I'm 5'3 , I weight 125 pounds
Peppy_23 same here.
Are there better running shoes that you would suggest? The brooks beast is the shoe that I think you showed. However, I would think that shoe has too much cushioning and too big of a heel to toe drop. Wouldn't the cushion provide some instability of the metatarsals and the drop put more body weight on the toes.
Micky Kaufman I only showed the Beast because that is my running shoe and I had it in the closet. Specifically for sesamoiditis it is a good choice for very heavy runners or those who have rather severe excessive pronation. For others it is probably too much shoe. In general I would recommend a more neutral shoe such as the Brooks Adrenaline. Also, a Hoka One One with a rocker sole does a great job at reducing force on the sesamoids. There are a lot of shoes that will work well. The only type I would avoid completely if you have sesamoiditis are minimalist shoes. Those are fine for some issues, but not for forefoot problems.
Foot & Ankle Center of Washington Thanks for the responce, The Adrenaline still has a big drop like the beast so I would not consider the adrenaline as a first choice. Raised heels will increase pressure on the ball of the foot which something you'd want to avoid if possible with forefoot problems. Or do you disagree?
Rocker shoes would potentially dorsi flex the toes which I would think would be counter productive and place more pressure on the balls. However, I had seen an article that stated Hookas with the rocker soles helped reduce loading on the forefoot so may be worth a try. Hokas do have a low heel to toe drop which I think would be good. When I tried on a pair of the conquests a few years ago and during running I felt the cushion was too soft and my metatarsals would sink and shift during pronation. I'm not saying the Hokas you suggested would be the same as the conquest, but wouldn't the movement under that much cushioning be counter productive?
Micky Kaufman Great question, but the answer I think can get pretty complicated. In general I don't think there is one type of shoe best for sesamoiditis and I make suggestions to my patients based on there specific pathologies and mechanics. In general our primary goal is to reduce pressure and tension on the sesamoids (by reducing tension on the flexor hallucis brevis within which they are embedded).
If the heel rests in an everted position then one of the most important things we can do is limit heel eversion. In this situation a shoe with a very firm heel counter and firm midsole is preferred. Often these shoes do come with a greater drop which in some cases may increase force on the forefoot, but not likely as much as eversion of the heel which directly drives the medial forefoot (the sesamoids) into the ground. In the presence of equinus (tight heel cord) however, a greater drop can actually decrease pressure on the forefoot because a tight heel cord is a very strong pronator of the foot and the lift from the greater drop can decrease tension on the Achilles tendon. This has been demonstrated in many studies.
In a neutral foot with no equinus then I agree a shoe with less drop would likely be preferable.
Rocker soles such as on the Hoka usually do not dorsiflex the toes because the rocker is on the outer sole and not incorporated into the toe box of the shoe, which is generally flat. Many studies show that rocker soles decrease forefoot pressures. Also the rigid rockers decrease big toe dorsiflexion which in itself can decrease sesamoid pressure.
I try to keep the videos around 2 minutes in length so I really have to take a big picture approach in those. In clinic I am much more specific about the best shoes for particular patients.
Have a great holiday weekend.
Larry Huppin
Hi - I have this and the boot has made it worse - becasue it is squeezing the top of my foot with the strap is this normal?
No, it's' not normal. The boot is probably a poor fit for you. When I have patients who have trouble fitting our standard boots I usually recommend an Aircast boot. These tend to be more stable and have more room. You can see them here: amzn.to/2giUWD7
what could it be if the pain is more in the middle of the ball of the foot? Is it possible for a fracture there? morton nueroma?
There are several things that cause pain in this area. Capsulitis and Morton's neuroma are the two most common. Here is a page with links to detailed information on all of the most common problems along with some home treatment suggestions: www.footankle.com/pain-balls-feet/
Do you recommend carbon fiber insoles for this ..anybody has used carbor fiber insole for this. Thanks
Any sort of rocker sole - whether or not it has a carbon plate - will help with sesamoid pain.
The pages below provide detailed information on treatment of sesamoid pain, including home treatment options. If you start with home treatment, give it about 3 weeks and if you are not better see a foot specialist.
Sesamoid Pain Causes and Treatments:
www.footankle.com/pain-balls-feet/sesamoiditis/
Home Treatments for Sesamoid Pain:
www.footankle.com/self-care/ball-feet-pain-home-treatment/
can you explain to me what happens when two of your seseamoids rub against each other
Each sesamoid is embedded within a tendon. It is not possible for them to rub against each other
The edges of the moleskin dig into you foot and becomes very painful.
Does stem cells works for this condition doctor
Not likely - at least in the current research. Shockwave therapy is likely a more effective (and less expensive) method to stimulate healing.
I've been suffering from this for a few years. Pain would go up from my tie up my arch. When I run I tend turn in my right foot land on the ball of my foot and raise my big toe. Almost hyper extend it. I found a tape that goes from my arch to the ball and wraps around my big toe and stabilizes it. Try to be conscious of not putting my weight on the ball of my foot. Worst I get it now is when I wear old shoes to do yard work etc. It's more intermittent also try to wear a supportive insole on tha foot
See a doctor? He tell us to do the same thing you just did.God forbid if he says he has to operate,then he'll get in there and create other problems.