An accessory or navicular bone is an extra bone or piece of cartilage located in the inner center arch of the foot near the navicular bone, the bone that goes across the foot close to the instep. The extra bone is congenital and fairly common, estimated to occur in approximately 2 to 12% of the general population. Amanda has the accessory navicular bone.
In early childhood, she didn’t notice it. In adolescence, when the accessory navicular began to calcify, the bump in the arch of her left foot became noticeable. Amanda felt pain in the inside of her midfoot in her early teens when playing sports.
When she was 15, she went to the doctor and was X-rayed and diagnosed with accessory navicular. Initial treatment is conservative, a medial heel wedge, anti-inflammatories, arch support, soft shoes, gel padding, healthy weight, custom orthotics, physical therapy, or a boot for a short time.
Conservative methods failed for Amanda. Her symptoms persisted and nothing relieved the pain and swelling in her foot, which worsened when on her feet for long periods of time or on the treadmill. Amanda is a retail store manager so is on her feet all day. Her condition is called accessory navicular syndrome caused by chronic irritation from shoes or other sources such as excessive activity or overuse. Her accessory bone is overly large causing this bump on the instep to rub against her footwear and hurt with every step.
Amanda came to DOC for relief. The orthopedic surgeon injected cortisone into the arch of her foot to reduce pain and inflammation. The treatment provided relief for many months. Amanda has a severe case of accessory navicular syndrome and her painful symptoms have returned. When the pain is unbearable she walks with a limp to try to reduce pressure on the bone protruding from the arch of her left foot. For Amanda, surgery to remove the accessory bone, reshape and repair the foot is the next step. The extra bone is not needed for normal foot function. She plans to schedule surgery with her favorite DOC surgeon in the near future.