Pain in this area, beneath your big toe, can usually be attributed to either a bunion or what’s called a sesamoid injury. bunion is a painful, bony bump that develops over time on the side of your big toe. Pressure on the big-toe joint caused by wearing shoes that are too tight or narrow can be a cause, Dr. Sutera says. People with a family history are more prone to this.Bunions are one of the most common foot injuries, and are up to 10 times more common in women than in men — perhaps due to our preference for narrow, pointed shoes.The usual treatment for a bunion is first wearing shoes that give your toes room to breathe — and icing your foot to alleviate any pain. However, if none of that works, and you still have pain or difficulty walking, your doctor may recommend surgery to have the bunion corrected.Another possibility is a sesamoid injur y. Sesamoids are bones in your body that aren't connected to other bones. Your kneecap is one example; it just floats atop your knee joint. You also have sesamoids in your big-toe joint. Like other bones, these can fracture due to high-impact injuries, like if you land too hard on your feet after a jump or a fall. But these bones (and the tendons around the bones) can also become bruised or inflamed due to overuse. This is most common among runners or ballet dancers who tend to put a lot of repetitive stress in that region of the foot.You can usually treat sesamoid inflammation by resting and icing your foot, or by wearing soft-soled and low-heeled shoes. If symptoms persist, your doctor might prescribe medication to reduce swelling — or have you wear a removable brace for four to six weeks.In the case of a fracture, you will definitely need to wear a brace or a cushioning pad to reduce the pressure, and it may take up to several months to heal.