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 How do you prevent Achilles tendonitis? 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.
This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse. Many people with accessory navicular syndrome also have flat feet (fallen arches). Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.
Perhaps the most common of the extra bones in the foot, the accessory navicular bone is estimated to be present in 7 to 19 percent of the population. Zadek and Gold maintained that the bone persisted as a distinct, separate bone in 2 percent of the population. Also be aware that the accessory bone normally fuses completely or incompletely to the navicular. It is this incomplete fusion which allows for micromotion, which, in turn, may cause degenerative changes that can also contribute to the pain.
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
Non-surgical treatments are enough to cure the symptoms caused by the accessory navicular. The treatment options include Immobilization, a cast or a walking boot is usually used to immobilize the foot so that the inflammation and pain are alleviated quickly due to the rest that the foot gets. Apply ice bags or wrap the ice in a towel and apply it on the aching region to alleviate inflammation. Orthotic devices that can be fit into the shoes are prescribe to keep the symptoms from resurfacing. Exercises are helpful for strengthening the muscles, which would not only help alleviate inflammation but also keep the symptoms from appearing again. NSAIDs and steroids may be prescribed as per the need of the patient to ease the pain and inflammation.
If non-surgical treatment fails to relieve the symptoms of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing the accessory bone, reshaping the area, and repairing the posterior tibial tendon to improve its function. This extra bone is not needed for normal foot function.
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