Orthopaedics

What is Accessory Navicular Syndrome?

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.

Accessory Navicular Syndrome

This syndrome is also referred to as os tibial naviculare or os tibial externum. As stated above, this condition quite often does not cause any pain. But if the posterior tibial tendon (the extra bone attaches to this tendon in the foot) or the accessory navicular bone itself were to get aggravated, then there would be pain.

Let us see the reasons why the tendon or the bone would get aggravated-

  • ankle or foot sprain
  • irritation of the bone caused by footwear
  • overusing the foot, quite common in athletes and dancers

People born with this extra bone are also known develop flat feet which also adds to the strain on the posterior tibial tendon and lead to the syndrome.

Signs and Symptoms

Most people born with this bone begin to experience the symptoms (if at all any) in adolescence. Some may not develop any symptoms until adulthood. The symptoms are-

  • a visible abnormal protrusion in the mid-foot
  • swelling and redness of the protrusion
  • pain in the mid-foot after performing an activity

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.

Ice

Apply ice bags or wrap the ice in a towel and apply it on the aching region to alleviate inflammation.

Orthotic devices.

Orthotic devices that can be fit into the shoes are prescribe to keep the symptoms from resurfacing.

Physical therapy

Exercises are helpful for strengthening the muscles, which would not only help alleviate inflammation but also keep the symptoms from appearing again.

Painkillers

NSAIDs and steroids may be prescribed as per the need of the patient to ease the pain and inflammation.

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.

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