Natural Treatment For Sesamoiditis

Dr. Angela Walk
22 hours ago
3 min read

Pain beneath the big toe? You may be suffering from sesamoiditis—a common yet underdiagnosed condition caused by irritation or misalignment of the sesamoid bones.

Left untreated, it can lead to chronic pain, difficulty walking, and degeneration of the forefoot.

This post explores what causes sesamoiditis, why conventional footwear is a major culprit, and how to heal naturally with conservative, foot-friendly solutions.

What Is Sesamoiditis?

Sesamoiditis is the inflammation, misalignment, or injury of the sesamoid bones, two small, pea-shaped bones located beneath the head of the first metatarsal bone, directly under the big toe.

These bones act like pulleys—assisting movement, absorbing pressure, and protecting tendons. When properly aligned, they glide smoothly in their grooves beneath the joint. But when disrupted, they become inflamed and painful.

Common Causes of Sesamoiditis

Blunt trauma or overuse (e.g., running, jumping, dancing)
High-impact sports on hard surfaces
Tight, tapered-toe footwear
Footwear with toe spring (raised toe box) or heel elevation
Poor big toe alignment (hallux valgus or bunion drift)

Did you know? When the hallux (big toe) is pulled inward by narrow footwear, it misaligns the sesamoid bones—forcing them out of their grooves and setting the stage for chronic irritation.

Symptoms of Sesamoiditis

Pain directly beneath the big toe joint or ball of the foot
Swelling, tenderness, or bruising
Pain when bending or extending the big toe
A sensation of “walking on a pebble”
Worsening pain with standing, running, or jumping

Natural Treatment & Recovery Strategy

Healing sesamoiditis takes time—and a load management approach. Because the sesamoids are under constant pressure when walking, rest and realignment are crucial. Here’s what I recommend:

1. Wear Foot-Shaped Footwear

The biggest change you can make is to transition to functional footwear.

Look for footwear that is:

Flat (zero-drop, no raised heel)
Wide at the ends of the toes
Flexible to allow natural foot movement

Flat, foot-shaped footwear decompresses the forefoot, allowing your sesamoids to glide naturally in their grooves instead of being jammed beneath the big toe joint.

Take a look at my Approved Shoe List of the footwear I approve and recommend for sesamoiditis and other foot conditions.

2. Use Toe Spacers for Realignment

Toe spacers realign the hallux with the first metatarsal, restoring the proper anatomical relationship. This gentle repositioning helps:

Reduce pressure on the sesamoids
Improve gait mechanics
Relieve big toe joint dysfunction
Prevent recurrence

Wear spacers daily during barefoot time or inside wide shoes.

3. Limit Activities That Load the Forefoot

During acute flare-ups:

Avoid sprinting, jumping, and prolonged standing
Limit shoes with thin forefoot padding on hard surfaces
Consider using a metatarsal pad to offload pressure

4. Manual Mobilization & Tissue Work

Gentle mobilization of the big toe joint and soft tissue release around the flexor tendons can promote healing.

Use a small massage ball under the arch and ball of foot
Perform myofascial release every other day to reduce tension

5. Immobilization (for Severe Cases)

If symptoms persist or sesamoid fracture is suspected:

Use a walking boot to offload completely
Immobilization allows inflammation to calm and bone to heal
Seek imaging to rule out a stress fracture if pain is sharp and persistent

Summary: Sesamoiditis Checklist

Action Step	Purpose
👟 Wear flat, wide, flexible shoes	Decompress forefoot, realign bones
🧩 Use toe spacers	Align the hallux, relieve sesamoid stress
❄️ Rest, ice, reduce loading	Control inflammation
🦶 Soft tissue work + mobility	Restore proper foot mechanics
🚶 Limit impact activities	Prevent reinjury during recovery
🛟 Immobilize if needed	For acute flare-ups or possible fracture

Final Thoughts From Dr. Angela

You don’t need invasive procedures or corticosteroid injections to treat sesamoiditis—just the right knowledge, tools, and a commitment to realigning your foot naturally.

Your feet are resilient. When given the space and support they need, healing happens.

Best of Foot Heath,

Dr. Angela

The Plantar Fasciitis Doc