[Guest]

I have had sesamoiditis in right foot for 2 1/2 years, and my surgeon has finally agreed to remove it (although his waiting list is 18 months long). When I initially had the pain, my doctor simply gave me Ibuprofen and codeine, then eventually (after about 2-3 weeks) diagnosed sesamoid pain and referred me to a podiatrist
I have read that strict rest is the best thing to help the inflamation, however, my podiatrist told me to use the foot normally, to the point of pain, or I would get "lesions" in the joint. Was this the best treatment, in your opinion? Do you think that this may have exacerbated the condition, to the point where surgery is now my only option?
I am not convinced that the podiatrist was competant, as he advised me that I should have a metataral reduction which would help - it was only because he was off sick the day of the surgery, and his boss was called in to do the surgery that this procedure was questioned - I was actually on my way to theatre.
I would value your opinion on this matter.

[Guest]

If you only have inflammation in the area which is sesamoiditis, activity such as walking is fine. Immobilization is more often used in cases where there is a sesamoid fracture. I am not sure what you mean by a metatarsal reduction. However, sesamoiditis can usually be relieved without surgery. Therefore, you may want to ask about other conservative treatments such as orthotics, cortisone injections and physical therapy. The cortisone injections into the area can be very beneficial and provide extended periods of relief. Have a nice day and please write back if you have any further questions.
[quote] I have had sesamoiditis in right foot for 2 1/2 years, and my surgeon has finally agreed to remove it (although his waiting list is 18 months long). When I initially had the pain, my doctor simply gave me Ibuprofen and codeine, then eventually (after about 2-3 weeks) diagnosed sesamoid pain and referred me to a podiatrist... [/quote]

[Guest]

Thank you for your response. I have had 2 cortisone injections - the first helped a little, the second not at all. Also have had orthotics, and a total of 3 months in plaster - none of which helped more than a little. My surgeon has now agreed that surgery is the only thing that may help, although he has only offered a 50/50 chance it will have any improvement. I also have a touch of arthritis in the big toe joint, which is made worse as I can't walk properly, which aggravates the joint. I am quite desperate now, so surgery seems the only answer.
[quote] If you only have inflammation in the area which is sesamoiditis, activity such as walking is fine. Immobilization is more often used in cases where there is a sesamoid fracture... [/quote]

[Guest]

The fact that you have arthritis in the big toe joint is interesting. It means that it is not working properly which will put extra strain on your sesamoids. The too most likely reasons for this is that your first metatarsal is too mobile or too long. Therefore, surgery to address this problem may improve your sesamoid problem and definitely help the arthritis from getting worse.
[quote] Thank you for your response. I have had 2 cortisone injections - the first helped a little, the second not at all... [/quote]

[Guest]

Xrays show the big toe joints are both abnormally flattened, giving reduced mobility, although only one has sesamoid pain or arthritis. No-one has said anything about it being too long, though.
By "surgery to address this problem" do you mean surgery to the metatarsal? I was supposed to have a osteotomy (section of bone removed from the metatarsal to reduce it's length), but was told that as both feet were the same, but there was only pain in one, this was unlikely to help.
I am keen to explore anything that will prevent the arthritis getting worse.
[quote] The fact that you have arthritis in the big toe joint is interesting. It means that it is not working properly which will put extra strain on your sesamoids... [/quote]

[Guest]

Arthritis can start in one joint before the other. Therefore, an osteotomy would be a good idea in the foot that hurts first and then possibly the other.
[quote] Xrays show the big toe joints are both abnormally flattened, giving reduced mobility, although only one has sesamoid pain or arthritis. No-one has said anything about it being too long, though... [/quote]