What is Accessory Navicular Syndrome?

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A condition that we at Texas Foot Specialists find comes as a surprise to most patients is something called Accessory Navicular Syndrome. A small extra bone or piece of cartilage found on the inner side of the foot right above the arch is at the root of this problem. Although present at birth, the extra bone may go undetected until adolescence or even adulthood.

Symptoms

Dull pain or throbbing in the middle part of the foot may be the first indicator of accessory navicular syndrome. A bony protrusion on the inner side of the foot may also be visible and can become red or swollen. Oftentimes this disorder manifests during adolescence when cartilage is turning into bone and bones are maturing and. The accessory navicular bone may be aggravated in a couple of different ways:

  • An injury or trauma to the foot such as an ankle sprain

  • Overuse or excessive and repetitive activity

  • Irritation from footwear that rubs against the extra bone

  • Having flat feet. This structural issue puts extra strain on the posterior tibial tendon which in turn can inflame the accessory navicular.

To confirm a diagnosis of accessory navicular syndrome, our podiatrists, Dr. Bruce Miller and Dr. Gregory Mangum, will physically examine your foot, looking for evidence of the bony prominence, skin irritation and/or swelling. An x-ray will most likely be ordered (which can be done in our Sugar Land 281-242-4448, Pasadena 281-991-0600, or Houston 713-664-6677 offices). The foot doctor will also assess muscle strength, joint motion, and gait.

Treatment Options

Surgery can be done to remove the extra and unnecessary bone. However, conservative treatment is preferred and so one or more of the following approaches may be tried first to relieve your symptoms:

  • Medication—oral nonsteroidal anti-inflammatory drugs or steroid injections may be used to reduce both pain and inflammation.

  • Icing—applying ice to the problem area can reduce swelling.

  • Physical Therapy—exercises that strengthen the muscles and treatments to decrease inflammation may be prescribed. It may be necessary to continue the exercises to prevent the symptoms from returning.

  • Custom Orthotics—this approach may be particularly effective if you have flat feet. Providing additional support for the arch through orthotics may alleviate the discomfort.

If you are experiencing any unexplained pain in your midfoot or any other part of your foot or ankle, contact us promptly for evaluation and treatment.