Accessory navicular syndrome is the painful condition caused by the presence of the accessory navicular. Well, is the statement a bit confusing? Let me explain. The accessory navicular is a bone in the foot that is not supposed to be present. But in some very rare cases, this extra bone (sometimes can also be a cartilage piece) is present by birth. This bone exists in the arch of the foot. The presence of this bone though not common, is not abnormal either as most people are not even aware of its existence unless and until it begins to cause pain which we call accessory navicular syndrome.
An accessory navicular develops as a result of a congenital anomaly and is found more often in women. If the bone is large, it may rub against a shoe, causing pain. Because of its location, the posterior tibial tendon may pull on the bone during walking or running, causing the fibrous tissue that connects the accessory navicular to the navicular to tear and become inflamed.
If you develop accessory navicular syndrome, you may experience a throbbing sensation or other types of pain in your midfoot or arch (especially while or right after you use the foot heavily, such as during exercise), and you may notice a bony prominence on the interior of your foot above the arch. This prominence may become inflamed, which means it will likely feel warm to the touch, look red and swollen, and will probably hurt.
To diagnose accessory navicular syndrome, the foot and ankle surgeon will ask about symptoms and examine the foot, looking for skin irritation or swelling. The doctor may press on the bony prominence to assess the area for discomfort. Foot structure, muscle strength, joint motion, and the way the patient walks may also be evaluated. 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 evaluate the condition.
Non Surgical Treatment
Traditional medicine often falls short when it comes to treatment for this painful condition. As similar to other chronic pain conditions, the following regimen is usually recommended: RICE, immobilization, anti-inflammatory medications, cortisone injections, and/or innovative surgical options. Clients familiar with Prolotherapy often say? no thanks? to those choices, as they know these treatments will only continue to weaken the area in the foot. Instead, they choose Prolotherapy to strengthen the structures in the medial foot.
The above non-surgical options should be enough to treat accessory navicular syndrome. If they fail, a surgery would be necessary to remove the extra bone that has been causing the problems. The most common procedure for this condition is known as the Kidner procedure where a small incision Why is my Achilles tendon burning? made over the navicular bone. The accessory navicular is identified and dissected free from the posterior tibial tendon. The posterior tibial tendon is then reattached to the remaining navicular bone.
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