Typically when you think of accessories, you think of shoes, purses, and jewelry that add a little extra style to your wardrobe. However accessory navicular actually refers to an extra bone on the inner side of your foot, incorporated into the posterior tibial tendon which attaches just above your arch. While jewelry is worn to be noticeable, this congenital condition often goes undetected. Unfortunately, though, for some it can cause painful problems.
Signs of the Syndrome
When the extra bone and/or posterior tibial tendon become aggravated, this is referred to as accessory navicular syndrome. A bony prominence may become visible in the area along with blisters, redness, tenderness, and inflammation. You may also experience leg fatigue, and pain or throbbing in your midfoot and arch, most often occurring after activity. Signs of the condition commonly appear during adolescence when bones are maturing, but may not occur until adulthood. Usually the navicular bone fuses with the accessory bone at this time, but in the case of accessory navicular syndrome, the bones form just a fibrous union, much like scar tissue, which can easily become strained.
While some people can possess this extra bone without problems, aggravating factors can lead to the syndrome’s symptoms. Trauma to the foot, like a sprain for example, excessive activity, and chronic irritation from footwear can all be culprits. In addition, those with flat feet are at greater risk as this type of foot structure increases the strain placed upon the posterior tibial tendon. Ice skating, ballet, and soccer are all sporting activities notorious for bringing on symptoms as well.
Putting an End to the Pain
An X-ray will typically be taken to confirm the diagnosis, and conservative treatment methods will be used to ease the symptoms. Immobilization is essential to reduce irritation of the area. This can be facilitated with a cast or walking boot. Ice and anti-inflammatory medication will help to minimize pain and swelling, as well. Oftentimes, orthotic shoe inserts are recommended to provide added cushion and support to your arch, which could additionally help prevent reoccurrence. Physical therapy exercises may also be used to strengthen surrounding muscles, decreasing the possibility of future problems. If symptoms are resistant to these treatments, surgery may need to be considered. This typically entails removal of the extra bone, repair of the posterior tibial tendon, and reshaping of the arch.