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Updated: Aug 26, 2019


Why am I getting pain under my big toe?

Pain under the ball of your foot, especially under the big toe joint could be indicative of sesamoiditis. Sesamoids are two small bones that are located under your big toe and because of this position they are often under excessive loads. Due to this, these bones can become irritated or inflamed and, in some cases, they can fracture.  


Sesamoiditis often has a gradual onset, whereas fractures of the sesamoid are instant. The main causes of sesamoiditis include: increase in activity levels, constantly wearing high heeled shoes, repetitive walking uphill, reduced fat pad under the sole of your foot and having a high arched foot type. There may be other causes, related to the way you walk.


  • Pain under the ball of your foot, specifically under the base of the big toe.

  • Swelling and bruising around this area.

  • Occasional pain when bending or straightening the big toe.

  • Pain worse in high-heeled shoes.


Treatment for sesamoiditis includes: resting and icing the area, taking anti-inflammatory medications, wearing shoes with a low heel and softer sole, deflective padding, immobilization taping, steroid injections and custom-made orthotics. For fractures of the sesamoid: you may also need to immobilize your foot in a special boot during the initial phase of the treatment. If conservative treatment measures fail, then your Podiatrist can refer you for a surgical opinion. In either case, a proper diagnosis and treatment is important, so come in and see your podiatrist!

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