The accessory navicular is an extra bone or bit of cartilage in the arch of the foot that may or may not bring about issues. It is also called an os navicularum or os tibiale externum. It is included inside the tendon of the posterior tibial muscle that attaches in the navicular bone. The extra bone is on the medial side of the navicular bone that is the bone which is near the top of the mid-foot (arch) of the foot. It takes place in anywhere from 5-15% of the population. It is not often a problem, however the prominence of the bone could make stress from the shoes painful. From time to time the accessory bone is in such a position which it will impact the angle of pull of the posterior tibial muscle which generally impact foot function and will trigger a variety of alignment concerns, like a flat foot.
The diagnosis is usually by x-ray where the presence of the accessory bone is clear. There are lots of types that the x-ray might help figure out which one it is. The Geist grouping separates the accessory navicular bones in to three different types. Each one of the 3 kinds has an effect on the structure and biomechanics in the foot in a different way and each of the 3 different types requires a distinct treatment strategy.
The goal of treatment methods are to relieve the symptoms and prevent it remaining painful. When the pain is extremely bad, then placing the foot in a cast or removable walking boot allows the affected region to rest and help the symptoms. Ice could also be used to lessen swelling. Oral nonsteroidal anti-inflammatory drugs (NSAIDs) may be used in combination with immobilization to help reduce the inflammation and pain. Physical exercises and treatment options to strengthen the muscles might also be recommended, especially over the long term that will help avert a recurrence in the symptoms. Foot orthotic inserts are usually also very beneficial to protect the foot and become especially useful when the accessory navicular causes a flat foot. There really are no best shoes for an accessory navicular.
The accessory navicular bone is usually a unique issue is sports activities such as skiing as well as ice skating. It is because the boots of these sports will go around the feet and its rather inflexible. So, if anyone has a enlarged area of bone on the feet, such as an accessory navicular, this could be fairly painful and also not easy to manage. Things like doughnut shaped padding to deflect the pressure from the shoes off the prominence is usually valuable. This is also where the knowledge of a boot maker or a competent ski boot fitter will be invaluable. These experts are used to handling these sorts of complications and can change the boot around the acessory bone so it will be more at ease. A podiatric doctor can often help with all of this.
If the traditional nonsurgical treatments will not ease the pain, after that surgery might be indicated. Surgical procedures could involve taking out the extra bone, re-shaping the area and correcting the tendon to better its biomechanics. This additional bone isn't really required for normal foot function, thus in principle it will not be an issue.