Too much pressure under the big toe joint in the foot can cause a painful callus to develop there over time. However, that too much pressure can also inflame and irritate the small sesamoid bones that are under the big toe joint. So how do you tell if the callus is the source of the pain or the inflamed tissues around the sesamoid bones are the source of the pain? Or has the higher pressures caused both problems?
You may go to the podiatrist with what you think is a painful callus under the big toe joint. The podiatrists may do a really good job of debriding that callus and you go away thinking the problem has been relieved, but the pain is still just as bad. This does happen often. What has happened was that the despite the callus being obvious, the problem was not the callus, but a sesamoiditis or inflammation of the deeper tissues in the same area where the callus was.
If this is the case, then the treatment for the sesamoiditis needs to be different. This will involve the use of felt pads or insole top get the pressure off the area to make it more comfortable so the inflammation can settle down. It could also be that the callus was an irritant that increased the pressure and caused the sesamoiditis, so that callus may need to be regularly debrided.
What is important that the diagnosis is right and the right treatment started.