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 owing to soring pain in my right foot below the great toe.

As I did not want to take any chances, I immediately consulted an orthopedic. The doctor ran some tests and said it was just some muscular pain. A regular soak in warm water with Epsom salt would suffice was the suggestion. I took it and went back to my regular activities, though this time with 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 something called as 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 being interrupted, the bone starts to decay.

After being cognizant 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 the recovery, an 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 to talk so elaborately about my condition and the doctor’s 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 treatment. People appreciate the value of the sesamoid bones once they are fractured or worse they are diagnosed with AVN.

Damaged Foot Sesamoids?

When the sesamoid is fractured, the pain is unbearable. The condition might get worse in case of an AVN. The inclination would be to get rid of the pain through 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/rejuvenate itself. It can re-grow the foot sesamoid bone which has been affected by AVN. The only care that needs to be taken during the healing – no excessive pressure by walking/running/jogging which can deform the bone.

Hence a simple question,

Why not believe in the regenerative abilities of the body? 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. With control on the uric acid through my diet, I am confident 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

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

Add yours

  1. What i don’t understood is in truth how you are now not actually a lot more smartly-appreciated than you might be right now. You are very intelligent. You already know therefore significantly with regards to this topic, made me in my opinion believe it from numerous various angles. Its like women and men are not fascinated unless it is something to accomplish with Girl gaga! Your personal stuffs great. All the time deal with it up!

  2. Hi, what was the medication you took please, to help re-establish blood supply to the sesamoid?

    1. Hi Helen,

      Thanks for your message

      The meds were as follows:

      1) Alendronic Acid (70mg) on a weekly basis for 6 weeks to revascularize the area

      2) Some Calcium & Vitamin D tablets for speeding up the process

      Hope you find it helpful

      Have a good day

  3. Your style is really unique in comparison to other folks I’ve read stuff from. I appreciate you for posting when you have the opportunity, Guess I’ll just book mark this blog.

  4. Can I simply say what a comfort to discover someone who really knows what they are discussing on the internet. You certainly know how to bring a problem to light and make it important. A lot more people really need to look at this and understand this side of your story. I can’t believe you are not more popular given that you most certainly have the gift.

  5. I have a question. I went through trauma I was in a bad wreck when I was 16 , I went thru breaking my femur , a lot of nerve damage resulting in surgical equipment being inserted inside my femur and my foot. My problem is my right foot right now I have like this hard are of like tough skin and it’s excruciating pain when it’s you or when I bare weight on my right foot. I’m just really scarred to get it check out bc I may have to go under surgery, if this occurs this will b my second surgery on my foot I don’t want that, I work full time, I know my health is very important , I’m also in nursing school. I’m very active I stand do a lot of walking and I’m just wondering what is this pain that is causing my foot. It’s right under my big toe, very very similar to the first picture in the upper left page

    1. Hi Melissa, Thanks for sharing your experience and for writing on the blog topic. I had written about this as I wanted to convey that surgery is not essential at all to deal with this issues. Even if you have AVN, conservative approach of modified soles, support and cast can help. Do not push yourself for a surgery. Please let me know if you have further questions.

  6. Hello! I would like to ask you, how do you feel now? Did you heal your sesamoid bone 100%?
    I have similar problem.

    1. Hello Vasilii, Good to hear from you. Yes, with the help of padding insoles, less load on the impacted foot, and basic meds(vitamins), I am now completely in a position to go back to my normal life. Hope you are also doing well.

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