Accessory Navicular Syndrome is a painful condition that develops as a result of an extra bone or piece of cartilage on the inner side of the foot just above the arch. Trauma, such as a foot or ankle sprain, chronic irritation from shoes or other footwear rubbing against the extra bone, and overuse or excessive activity can be the cause.
Signs and Symptoms:
Symtoms of Accessory Navicular Syndrome include:
• A visible bony prominence with swelling and redness on the inner side of the foot just above the arch (midfoot)
• Vague pain/ throbbing in the midfoot and arch generally during or after activity
Diagnosis:
Diagnosing navicular syndrome involves examining the foot for skin irritation or swelling, evaluating discomfort by pressing on the bony prominence, assessing the foot structure, muscle strength and joint motion, and observing the patient walk.
Treatment:
Non-surgical treatments can relieve symptoms and may include:
• A cast or walking boot to immobilize the foot (allowing the affected area to rest and reducing inflammation)
• Applying ice covered with a thin towel to the affected area to reduce swelling. Never apply ice directly to the skin.
• Prescribing oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. Sometimes, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation.
• Physical therapies to strengthen the muscles and decrease inflammation, which may also help prevent symptom recurrence.
• Orthotic arch support shoe inserts, which may play a role in preventing future symptoms.
Symptoms will sometimes reappear, even after successful treatment. In this case, the treatments are usually repeated. If non-surgical treatments are not successful, surgery may be appropriate. Surgical treatment may include removing the extra bone (which is not needed for normal foot function), reshaping the affected area, and repairing the posterior tibial tendon.
