An accessory navicular is congenital (present at birth). It is not part of normal bone structure and therefore is not present in most people.
- Trauma, as in a foot or ankle sprain
- Chronic irritation from shoes or other footwear rubbing against the extra bone
- Excessive activity or overuse
Adolescence is a common time for the symptoms to first appear. This is a time when bones are maturing and cartilage is developing into bone. Sometimes, however, the symptoms do not occur until adulthood. The signs and symptoms of accessory navicular syndrome include:
- A visible bony prominence on the midfoot (the inner side of the foot, just above the arch)
- Redness and swelling of the bony prominence
- Vague pain or throbbing in the midfoot and arch, usually occurring during or after periods of activity
X-rays are usually ordered to confirm the diagnosis. If there is ongoing pain or inflammation, an MRI or other advanced imaging tests may be used to further evaluation the condition.
The goal of non-surgical treatment for accessory navicular syndrome is to relieve the symptoms. The following may be used:
- Immobilization. Placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation.
- Ice. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin.
- Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation.
- Physical therapy. Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms.
- Orthotic devices. Custom orthotic devices that fit into the shoe provide support for the arch, and may play a role in preventing future symptoms.
If non-surgical treatment fails to relieve the symptoms of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing the accessory bone, reshaping the area, and repairing the posterior tibial tendon to improve its function. This extra bone is not needed for normal foot function.
If you believe have a foot problem and do not currently see a podiatrist, call one of our six locations to make an appointment.
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