More often or not, anytime i throw up an foot x-ray, the 1st thing a patient asks me is “what are those round white spots?” These are called the sesamoid bones and are important in normal gait allowing the big toe joint the range of motion necessary for pain free ambulation.
Sometimes, however, these tiny bones can be come traumatized leading to inflammation and pain. Sesamoiditits is typically an overuse injury that results in repetitive trauma to the sesamoid bones. Pain is typically located under the ball of the foot. The tibial sesamoid is the most commonly affected bone in this condition.
Initial treatment usually involves shoe gear modification in the form of a dancers pad. This type of injury is prevalent throughout the dancing community, especially ballet dances due to the considerable of time spent on the ball of the foot. A dancers pad, is a pad with a special cutout near the ball of the foot, that allows for the weight of the body to be transferred more laterally, thereby taking pressure of the inside of the foot.
Further treatment usually involves prescription NSAIDS, application of ice, and possible need for a steriod injection. In really difficult cases orthotic devices may be prescribed with a dancers pad cut out built into the device itself