bruised sesamoid

by Singing the Sesamoid Blues
(Canada)

Left foot ball below the big toe joint, No redness or bruising evident on skin, however very painful. Began two days ago with pain in centre of foot, moved to sesamoid bone area and has stayed put. Swollen day two and three. Very painful day three- I was however trying to walk on it. Xray shows no fractures or breaks according to Doctor. I have applied ice and heat and kept off it on day four (today). I am having hot baths, taking arnica and applying it topically. The foot begins to pain if touched, if I stand upright with it off the floor for too long and of course if I try to walk on it. Day one and two I could move big toe and all toes no problem, today I cannot move any of my toes. The range of motion of the foot is limited to downward movement. I cannot move foot upward without great pain. I am keeping foot elevated and keeping off of it.

I believe I may have bruised the bone on day one when walking on uneven ground. I wear sensible shoes - low, roomy and good soles most of the time. I had the middle of the foot pain on Day two and had a massage that day in which the practitioner twisted the foot sideways and was working quite deeply. I also had it seen by a doctor that diagnosed Sesamoid bruising. Day three I was trying to walk and everything seemed to aggrevate it. I had it seen by another doctor and had it xrayed. Day four was today and I stayed off of it. It is still sore to touch and aggrevated by movement, but not throbbing with pain.

I do not believe it is Gout as I am a vegetarian with fish intake twice weekly and tofu once or twice a week, the rest of my diet is comprised of grains, veggies, nuts and the occasional cookie, I eat yeast free bread occasionally. I drink smoothies in the morning with msm, lethicin, Greens Plus for bones or detox, flax or Omega oils (3,6,9) and bee pollen. The smoothies are only 4 days a week. Otherwise, I have cereal with soy or almond milk, toast and eggs. I drink lots of water and tea all day long. Occasionally, I eat cheese and drink red wine. I have not drank wine for two weeks now and my last intake was a typical one to two glasses with supper.

Is there anything else I can do? I have to travel in four days. How long will this take to heal?

Hi Tracy,
You do not mention if you are male or female, nor your age, but in spite of your diet you still have to rule out gout. The good news is that gout attacks are usually self limiting and will gradually get better on its own over the course of a few days to a week.
Sesamoiditis is also a very real possibility based on the location of pain, BUT, most people who come in with a red, hot swollen foot have more than just a sesamoiditis. In spite of the x-ray there is a very real chance you have a fractured sesamoid which in many cases will not show up.
If this pain persists longer than a few days, you might want to request an MRI which will be better at diagnosing a fractured sesamoid. The fact you spent day one walking over uneven terrain would be a vote for a fractured sesamoid.
Do not take aspirin for the pain but try Naprosyn which is indicated for gout, so that if it is gout at least the Naprosyn will relieve the symptoms and will also help the symptoms of a fractured sesamoid.
In either event you need to follow up on this.
Good luck.
Marc Mitnick DPM