Avascular Necrosis (AVN) of the foot sesamoid bone – What is the right course of action??

This brief note is meant to shed some light on the queries that might arise regarding injuries & treatment for the foot sesamoid bone.

Currently, I am recovering from a worst possible scenario – sesamoid bone necrosis or sesamoid AVN in my right foot. I also suffer from high Uric Acid, which is compounding the problem.


Let me give a brief about myself. I had a very active lifestyle which included running, badminton, trekking & biking. After one instance of long trekking in January 2014, I started feeling uncomfortable and soring pain in the front part of my right foot.

As I did not want to take any chances, I immediately consulted an orthopedic doctor. The doctor ran some tests and said it is just some muscular pain and it will go away by soaking my leg regularly in warm water & Epsom salt. I took his advice and went back to my regular activities, though this time with some slight pain.

Finally, in March 2016, I started to experience heavy swelling in the foot. The doctors I met, proposed that there was only one solution left – surgery (to remove the sesamoid bone).

I was confused!!

Suddenly Surgery?? Why? Side Effects?

There were more questions than answers?

It just did not make sense…..


I took a divergence from the doctor’s opinion as I was not convinced with the logic of surgery. In my opinion, surgery was supposed to be the last resolve rather than a first one.

I did a 3T(Telsa) MRI scan to understand what was the cause of the pain. The root cause turned out to be Avascular necrosis (AVN) of the sesamoid bone. In this condition, cell death (necrosis) of the bone happens due to interruption of the blood supply. This interruption can be due to injury during some physical activity or excessive alcohol consumption or some genetic causes. With the blood supply interrupted, the bone starts to decay.

After knowledge of my condition, I met more specialists in the field. There was indeed a difference of opinion ranging from – painkillers to surgery.

Finally, I zeroed in on an experienced doctor who explained to me about the significance of sesamoids and how AVN can be reversed. He put me in a synthetic-cast and started medications to establish the blood supply (re-vascularize) the bone. This went on for a period of 40 days.

After this, I was made to walk around with surgical inserts in my shoes. To gauge recovery,  MRI was conducted at intervals of 6-8 months. The doctor had also asked me to keep wearing cushioned sports shoes all the time and never walk barefoot till complete recovery could be established. This was meant to speed up the revascularization process.

There is a backdrop for me talking so elaborately about my condition and how my doctors decided to approach the problem.

What are Sesamoid Bones?

Let’s talk briefly about the sesamoid bone. It is a tiny pea-shaped bone embedded in the tendon at the bottom of both feet. They act like pulleys for the tendons to glide over them. By this analogy, you can make sense that despite being small sesamoids are very helpful.

The instances of AVN occurrences in the foot sesamoid bone is a small fraction. This speaks volume regarding its awareness and its treatment. People appreciate the value of the sesamoid bones in the foot once they are either fractured or worse case AVN.

Damaged Foot Sesamoids?

When the sesamoid is fractured, the pain is unbearable. The condition might get worse in the case of AVN. The inclination would be to get rid of the pain through a surgical intervention. There are surgeons who propose this alternative for quick relief. This quick/instant relief comes at the cost of the instability of the great toe and further future complications. The primary objective of going back to running barefoot on grass etc. may possibly never ever be fulfilled. So why do the surgery??

Natural Healing

With proper care, the body can miraculously regenerate and rejuvenate itself. It can re-grow the foot sesamoid bone which is affected by AVN. The only care to be taken during this process is to not deform the bone by putting pressure(by walking/running/jogging) on it.

Why not believe in the regenerating abilities & let it do its job? Why take shortcuts?

Image result for no to surgery

Fig 1. Say NO to Surgery and give “Natural Healing” a chance[2]

Just by adhering to these steps, I have recovered about 80% of my sesamoid bone and walking strength back. With control on uric acid/diet, I am confident & optimistic that the final lap will also be cleared. 🙂

Image result for natural healing by body

Fig 2. Self-help Author & Speaker, Wayne Dyer’s view on “Natural Healing”[3][4]


This is my personal experience. Share your views in the comments section or email me at u2d2tech@gmail.com.



  1. https://www.theinsolestore.com/blog/save-your-sesamoids-eliminate-sesamoiditis-heres-how/sesamoids/
  2. https://www.pinterest.co.uk/pin/105693922484037675/
  3. http://www.azquotes.com/quote/923180
  4. https://en.wikipedia.org/wiki/Wayne_Dyer

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