Chronic Sesamoid Pain: Possible Relationship to the Presence of Bunions

This is a great review of something I think about, but probably do not consul patients regarding. The blog patient commented to me how their chronic sesamoid pain could be related to a developing bunion. This is true since bunions are produced by a malalignment of the big toe joint and that malalignment can be a cause of chronic inflammation in the joint. Where does inflammation in the big toe joint tend to settle? Well, gravity pulls the swelling down around the sesamoids. So, one or both sesamoids can hurt on examination even if they are not injured themselves. This can lead to inappropriate sesamoid removal. You can get some idea of the role of the bunion has on the sesamoids by treating both the malignment and inflammation for a good two weeks. This would include toe separators or bunion taping (both can be found in this blog), and contrast baths each evening as a deep flush. You have go two full weeks to check, and not wear tight shoes that shove the bunion in the wrong direction. Hope this helps some of you guys. Thanks to the person who sent me the article!! I will answer them privately. 

https://www.sciencedirect.com/science/article/abs/pii/S1268773111000154