The accessory navicular is an extra bone fragment or bit of cartilage in the arch of the foot that may or may not cause issues. It is usually referred to as an os navicularum or os tibiale externum. The bone is integrated inside the tendon of the posterior tibial muscle which attaches in the navicular bone. The additional bone is on the medial side of the navicular bone which is the bone that is towards the top of the mid-foot (arch) of the foot. It is present in from 5-15% of people. It's not often a concern, however the prominence of the accessory bone can make strain from the shoes painful. At times the accessory bone is at such a place that it can affect the angle of pull of the posterior tibial muscle that might affect foot functionality and could result in a variety of alignment concerns, like a flat foot.
The verification is generally by x-ray in which the existence of the accessory bone is clear. There are many types that the x-ray might help ascertain which one it is. The Geist grouping separates the accessory navicular bones in to 3 different types. Each of the 3 kinds has effects on the structure and biomechanics in the feet in different ways and each of the three different types needs a unique therapy process.
The aim of treatment methods are to alleviate the signs and symptoms and prevent it remaining painful. If the pain is extremely bad, then putting the foot in a cast or easily-removed walking boot will allow the affected region to rest which helps the pain. Ice may also be used to lessen inflammation. By mouth nonsteroidal anti-inflammatory drugs (NSAIDs) may be used combined with immobilization to further lessen the inflammation and pain. Exercise routines and treatments to strengthen the muscles could also be suggested, especially over the long term that can help avoid a repeat in the symptoms. Foot orthotic inserts are generally extremely useful to protect the region and become certainly useful if the accessory navicular is bringing about a flat foot.
The accessory navicular can be a unique concern is sports for example skiing as well as ice skating. It is because the footwear of these sporting activities will go right around the foot and it is rather stiff. Therefore, if someone has a enlarged piece of bone on the feet, just like an accessory navicular, this is often rather painful and in addition hard to handle. Items like doughnut shaped pads to remove the pressure from the boot away from the spot is frequently advantageous. This can be where the skills of a boot maker or a experienced ski boot fitter is very helpful. They are used to managing these sorts of issues and can alter the boot around the prominent navicular so it will be more at ease. A foot doctor can frequently assist with all of this.
When the conservative non-surgical therapies really don't eliminate the symptoms, then surgery may be indicated. Surgery might include getting rid of the accessory bone, re-shaping the spot and reconstructing the posterior tibial tendon for increasing its biomechanics. This accessory bone will not be required for normal foot function, and so in theory it won't be a problem.