Accessory Navicular Syndrome: Symptoms, Non-surgical Treatment Options

While on vacation, Caroline fell down a step and injured her foot. She discovered later that she had an extra bone in her foot called the accessory navicular bone, which the fall had injured. Please continue reading to find out more about Jessica’s surgery and the care she received from Dr. Katherine Solway. Learn more about Accessory Navicular Syndrome, including its causes, methods of diagnosis, treatments, and surgical procedures.

What exactly is an Accessory Navicular? 

A navicular accessory is a supplementary bone that is connected to the navicle. A correctly functioning navicular is a small, flat bone that forms the interior portion of the foot’s arch. An accessory navicular develops when fibrous tissue or cartilage connects an extraneous bone to the navicular. Accessory navicular syndrome is congenital, so the additional bone is present at birth.

Despite the rarity of the condition, individuals with an accessory navicular may be unaware of their condition. Nonetheless, some individuals with this condition may experience foot discomfort or have an increased risk of a foot injury.

What precisely is Accessory Navicular Syndrome?

People with an accessory navicular are generally unaware of their disease if it does not create any complications. When the bone and/or posterior tibial tendon are exacerbated, some persons with this additional bone develop a painful condition called supplementary navicular syndrome. This may happen as a consequence of any of the following:

Trauma, such as a sprained foot or ankle

Chronic discomfort caused by shoes or other footwear pressing on the excess bone

Excessive physical activity or overuse

Many patients with accessory navicular syndrome experience flaccidity.

Accessory Navicular Syndrome Symptoms and Signs

Adolescence is a frequent period for symptoms to emerge. This is the stage during which bones mature and cartilage develops into bone. However, the symptoms may not appear until maturity in certain cases. The followings are the signs and symptoms of the accessory navicular syndrome and Achilles Tendon Rupture:

  • A prominent bony protrusion on the midfoot (the inside side of the foot, directly above the arch)
  • The bony protrusion is red and swollen.
  • Pain or throbbing in the midfoot and arch, often during or after periods of activity


The foot and ankle surgeon will inquire about symptoms and inspect the foot for skin irritation or edema to identify the accessory navicular syndrome. The doctor may apply pressure on the bony prominence to examine for pain. Foot structure, muscular strength, joint mobility, and the patient’s walking style may all be assessed.

X-rays are often used to confirm a diagnosis. If the pain or inflammation persists, an MRI or other sophisticated imaging tests may be utilized to further assess the issue.

Non-surgical Treatment Options

Non-surgical therapy for accessory navicular syndrome aims to alleviate symptoms. The following are examples:

  • Immobilization. Placing the injured foot in a cast or detachable walking boot enables it to rest and reduces inflammation.
  • Ice. A bag of ice wrapped in a small towel is placed on the afflicted region to minimize swelling. Do not apply ice straight to your skin.
  • Medications. Nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen may be taken orally. To relieve pain and inflammation, oral or injectable steroid medicines may be administered in conjunction with immobilization in certain circumstances.
  • Physical therapy. Physical therapy, which may include exercises and treatments, may be recommended to strengthen the muscles and reduce inflammation. The exercises may also aid in the prevention of recurrence of the symptoms.
  • Orthotic devices. Custom orthotic devices that insert into the shoe give arch support and may help to avoid future complaints.

Symptoms of the auxiliary navicular syndrome might return even after good therapy. When this occurs, non-surgical alternatives are frequently tried again.

When do you need surgery?

If the treatment that doesn’t involve surgery doesn’t help the signs of extra navicular syndrome, surgery may be the best option. During surgery, the extra bone may be taken out, the area may be reshaped, and the posterior tibial tendon may be fixed to make it work better. This extra bone is not necessary for the foot to work normally.

Why choose a surgeon for your feet and ankles?

Foot and ankle doctors know the most about how to take care of feet and ankles today. As doctors of podiatric medicine, also called podiatrists, DPMs, or sometimes “foot and ankle doctors,” they are the board-certified medical experts in the podiatric field. Foot and ankle doctors have more education and training about the foot and ankle than any other type of doctor.

Foot and ankle doctors treat all kinds of easy and complicated foot and ankle problems in people of all ages, including Accessory Navicular Syndrome. Foot and ankle doctors have a lot of education and training, so they can do a wide range of treatments, including any surgery that may be needed to treat Accessory Navicular Syndrome.

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