Accessory Navicular Syndrome

Accessory Navicular Syndrome is a painful condition caused by irritation to the accessory navicular, a bone or piece of cartilage which is found in some, but not all, people. An accessory navicular is found on the inner aspect of the foot, on the arch, over the navicular bone, within the tendon of the tibialis posterior muscle. The presence of an accessory navicular is genetic; it is not acquired. However, symptoms often appear only later in life and may go unnoticed until it begins to cause problems. People typically first develop symptoms during adolescence, however, for some people, symptoms only appear in adulthood.

Trauma, including foot or ankle sprains, chronic irritation of the bone, such as that caused by footwear rubbing against it, and excessive activity or overuse, particular of the tibialis posterior muscle, can lead to redness of the area, swelling and enlargement of the bony prominence, and pain or throbbing in the medial (inside) portion of the foot. When this happens, we can say that someone how developed “Accessory Navicular Syndrome”. It is also often connected with excessive pronation of the foot, as this causes increased activity and stress on the tibialis posterior tendon, leading to inflammation or irritation of the accessory navicular.

This condition is usually diagnosed through a physical examination of the foot and/or by X-ray. Treatment involves placing the foot in a cast or removable walking boot that reduces the stress on the affected tissues, using rest, ice, compression, and elevation to reduce swelling (put ice in a tea towel…don’t put ice directly on the skin), taking non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, using function in-shoe orthotic devices to reduce the stress on the affected tissues by improving foot function and gait, and prescribing a set of therapeutic exercises to address muscle imbalances that may be contributing to this condition. Acupuncture may also be helpful to reduce inflammation and pain.

If these methods are not enough to manage a person’s condition, then surgery may be needed to remove the accessory bone, reshape the area, and repair the tibialis posterior tendon. Thankfully, the accessory navicular is not believed to be necessary for foot function, as it is absent in most people.

%d bloggers like this: