Is there any treatment for recurrent sesamoiditis of my L great toe

The evidence for treating recurrent sesamoiditis is thin and mostly comes from small surgical case series, not from trials comparing conservative care to surgery or to doing nothing.

The only treatment studies retrieved are about sesamoidectomy, the surgical removal of the sesamoid bone. One 2012 series of 24 athletic patients with sesamoid fractures that failed nonoperative care reported high rates of return to activity and significant pain relief after surgery [2]. A 2004 review of isolated tibial sesamoidectomy found that in one recent series, 80% of 32 patients had excellent pain relief and 90% returned to normal activity [3]. But these are small, uncontrolled case series from the manufacturer of the procedure itself, not independent trials. They also studied fractures, not the recurrent inflammation (sesamoiditis) you describe.

A 2025 narrative review on foot osteochondroses (which includes sesamoid involvement) advocates conservative management first: rest, activity modification, offloading, physical therapy, and orthoses [1]. It notes that acute surgical interventions have been largely abandoned except for residual deformity or osteoarthritis in adults [1]. No retrieved study compares conservative care to surgery for recurrent sesamoiditis specifically, and no study compares either to no treatment.

The evidence does not answer whether any treatment changes the long-term course of recurrent sesamoiditis. The surgical data is from small, uncontrolled, industry-adjacent case series on fractures, not on your condition. The conservative approach is the standard recommendation but has not been tested against surgery or against natural history in a controlled trial for sesamoiditis.

My call: The available evidence does not establish that any treatment, surgical or conservative, changes the long-term outcome of recurrent sesamoiditis. Surgery may relieve pain in the short term for some people, but the studies are too small and uncontrolled to trust the numbers. Confidence: low — the evidence base is too thin to guide a confident choice.