Sesamoiditis

Sesamoiditis

Sesamoid bones are bones which act as a pulley; they are attached to the tendons and are embedded in the muscles. They provide a smooth surface for the smooth movement of the tendons. These types of bones are found in various joints of the body, but more commonly seen in lower extremities. Two such bones are located around the ball of the foot. It is seen behind the first metatarsal joint of big toe. Patella is one of the largest sesamoid bones of our body. Sesamoiditis is a form of tendinitis. It is defined as fracture of the sesamoid bone or inflammation or irritation of the tendon surrounding it.

Causes and risk factors

Like any other fracture, the major cause of sesamoiditis is road accident or vehicle injury. Fall, which causes severe pressure or force on the bone, can lead to its breakage. Indirect trauma can also lead to sesamoiditis. Microtrauma resulting due to repeated force or trauma is another contributing factor seen. This is particularly seen in various sports activities like tennis, baseball, golf, hockey, basketball , and in ballet dancers. Various bone disorders can too add up to its causation. Arthritis and osteochondritis are the major contributing factors. Growth of extra tissues under the sesamoid bone can also evoke pain and can lead to this condition.

 

Clinical presentation:

Pain is a prominent feature seen. The pain comes up gradually or it can be immediate in case if the bone is fractured. Pain is aggravated by movement. Hence, restricted movement is seen. Along with this, swelling and bruising are the other complaints. On examination, tenderness is present.

 

Investigations:

Diagnosis is done on the basis of the symptoms narrated by the patient. Certain physical tests are carried out by the doctor which helps in confirming the condition. Investigations like x-rays, CT scan, and MRI can be done.

 

Treatment:

Rest and restriction of activities which aggravates the pain is the first step to be adopted. Analgesic or nonsteroidal anti-inflammatory drugs are administered to relieve the pain. Application of cold pack and electrical stimulation helps is relieving the tension of the muscle. Wearing protective padding or cushions is advised. Injection of steroid medications can also be given. Physical therapy and stretching exercises are advised. Changes in lifestyle, especially in occupation which requires prolonged standing or overuse of the bone or muscle, is needed. In case of fracture, application of cast is done. In severe cases where the conservative method does not work, surgical intervention is needed.

 

Other Modes of treatment:

Certain other modes of treatment can also be helpful in coping up with the symptom. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Certain yoga exercises can also be helpful in strengthening the muscles.

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