There are 26 bones in a typical adult's foot, but every so often, a variation occurs and a person may develop an accessory navicular bone. An Accessory Navicular is a small extra bone that some people just naturally develop adjacent to the navicular bone (one of the bones that makes up the arch of the foot.) It is located inside the posterior tibial tendon, which is one of the major tendons coming into the foot.

Does an Accessory Navicular always hurt?
The vast majority of people with an accessory navicular will never know about it and it will never cause a day of pain. When an Accessory Navicular becomes inflamed and painful, it is known as Accessory Navicular Syndrome. It can happen because of trauma, overuse, or because of irritation from shoes. People with flat feet are more likely to develop pain from the accessory navicular or an inflamed posterior tibial tendon.

What does Accessory Navicular Syndrome feel like?
Pain of the accessory navicular can start in adolescence through adulthood. It will present with a bony prominence just above the arch of the foot. Because of pressure of shoes, this bump in the arch can become red, inflamed, and painful to the touch. Pain is also apparent in the arch, especially after activity.

How can Accessory Navicular Syndrome be treated?
At your Houston foot specialist's office, an x-ray will be taken to see if there is an accessory navicular present or if any other causes of your pain can be found. If an x-ray is inconclusive, other testing, such as an MRI, will be ordered.

The initial treatment of accessory navicular syndrome will be similar to other inflammations of the foot and ankle. A common treatment is RICE therapy: Rest, Ice, Compression, and Elevation. Anti-inflammatory medication will be prescribed. This includes oral medication, such as ibuprofen and other similar medications, and topical therapy, such as Biofreeze. Physical therapy may also be prescribed to strengthen muscles and decrease inflammation. Once inflammation is controlled, a custom orthotic may be used to help support the foot and prevent inflammation from returning.

Does Accessory Navicular Syndrome require surgery?
When non-surgical treatment does not provide relief of pain, your Houston foot surgeon will recommend surgery. This can involve the removal of the accessory navicular bone, which has no function and causes no weakness. The posterior tendon will also be repaired if necessary.

What should be my first step?
The first step to treating foot pain is a simple visit to your Houston Foot and Ankle Specialist, so we can evaluate your pain and discuss what the best course of treatment will be. Contact our podiatry office today to schedule an immediate appointment.