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The response to the question below was authored by Marc Mitnick DPM

Sesamoiditis w/fracture

by JC
(California)

Hello Dr. Marc,

I have seen a podiatrist and have had x rays which revealed a fracture in one of my sesamoid bones. The podiatrist felt the fracture was an injury from childhood that never fused. I am 49 now and I've had this recent injury for about 3 months brought on by overuse (running and golf) and it is only the last 2 weeks that I have committed to being non-weight bearing. It seems to have helped a bit with the swelling in the toe but not so much with the inflammation in the sesamoid area. Prior to fabricating this non-weight bearing shoe that allows my joint/toe to float I had walked on the outside of my foot and been hobbling around with great discomfort. For the inflammation, I've tried, Chinese herbs, advil, homeopathy, bromelian, Zymafled, and finally a shot of cortisone that caused major swelling and redness in the joint all the way to the tip of my big toe which lasted a week! So now 2 weeks into floating my toe and icing twice a day I am wondering how long until I might notice a difference in the swelling at the joint and how long until I may still experience the pain. I am also wondering if I should try advil or aleve in larger doses for several weeks instead the dose and time frame prescribed on the container. Also, should I still be icing? I have not worked out for months and would love to be able to walk again with out protecting my toe with every step. Do you have any suggestions as I would love some support? Thank you!!
ps My podiatrist devised orthotics which only made matters worse as the heel on them caused me to put more pressure on the ball of my foot and the rigid arch hit right under the sesamoids causing great pain and more inflammation so I have never been able to wear them.

Hi JC,
Well, hopefully the problems with the orthotics can be adjusted as I think that would be the first treatment you would want to try.
If, you actually have a fractured sesamoid (have you had a bone scan or an MRI?)and the orthotics do not help, you may have a problem.
You do not mention which sesamoid it is, but if it is the one closer to the second toe, then you might want to consider having it removed. If it is the other sesamoid, then removing it becomes a problem.
That is why I would recommend you work with your podiatrist in an effort to try and find an orthotic that takes pressure off the sesamoid, because beyond that there is not all that much you can do.

Marc Mitnick DPM

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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

MY PRODUCT RECOMMENDATIONS(items I prescribe in the office)

Orthotics for multiple types of foot pain best buy in a pre-made orthotic click link below

Orthotics for heel and arch pain for those who must wear dress shoes click link below

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Dear Dr. Mitnick, The orthotics arrived four days ago and I slipped them into my shoes immediately. I was skeptical as to the usefulness of the item, they really didn't look very exotic. I have to say though, after using them for just four days, I have experienced grand relief from my foot pain. Even the very first day, I was able to do a lot of work while on my feet with at least a 75% reduction of pain. It has only gotten better every day, and I go nowhere without my shoes with the orthotics. I had been experiencing extreme heel and sole pain for about six months and had to take extended breaks off my feet many times a day as well as regular doses of Ibuprofen. Since getting the orthotics, my life has returned to normal and I feel good again. Just wanted to say thanks for the recommendation for a very effective item, I had no idea what a change this item could affect.

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Unknown location

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New Zealand

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Sincerely

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Poland

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New Jersey

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Evansville, IA

Dear Marc

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San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY

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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

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location unknown

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

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location unknown

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Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

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Thank you. you were more detailed than what others have told me they finally called from the last xrays and my son is now in a cast for 2 weeks he did have a fracture that was not noticeable.

a mom

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Bellevue, WA

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