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Any thoughts on patient who has had sesamoid bone on left foot shaved. Now the adjacent bone is causing pain. Metatarsal pads (dancer gel pads) give no relief. Walking and standing is painful. No shoes are comfortable. How can I provide this patient relief without surgery which she's reluctant to have (again).

 

You can to use this method. This is a fast solution, but not definitive.

 

I deal with this condition frequently and it can be a challenge.
My best advice is to optimize biomechanics and off-load as best as possible with an foot orthosis.
If further reduction of pressure is required, an excavation in a stiff soled shoe filled with silicone is recommended.
This is often required when there is acute pain, as there is ltd. volume to work with in the orthosis and this a large joint. Done correctly this should provide significant relief.