Accessory Navicular Syndrome

What is an accessory navicular?
The accessory navicular is an extra piece of bone or cartilage located on the inner side of the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area and can lead to accessory navicular syndrome.

This is a congenital problem. It is not part of the normal bone structure and therefore is not present in most people.

What is accessory navicular syndrome?
People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone developed a painful condition known as accessory navicular syndrome when the bone or posterior tibial tendon are aggravated.

This can result from any of the following:
Trauma as in foot and ankle sprain
Chronic irritation from shoes or other foot where rubbing against the extra bone.
Excessive activity or overuse.

Many people with accessory navicular syndrome also have flat feet or fallen arches. Having a flatfoot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.

At our institution, we treat these problems conservatively. We use Regenerative Medical Therapy using Class IV Laser Therapy, Shockwave therapy, Stem cell injections, as well as oral Peptide. All of these can help alleviate pain of that particular area. If the pain has resolved, then no other treatment is necessary.

However, if there is severe pronation and collapsing of the foot then surgery may be needed.