Medical Issue

Accessory Navicular Syndrome

Accessory Navicular Syndrome

An accessory navicular is an extra bone that one in ten people are born with. The accessory navicular is located on the inner side of the foot just above the arch next to the navicular bone. It is within the posterior tibial tendon, which attaches to bones in that area. Accessory navicular syndrome is caused when this bone rubs against shoes causing pain, or when the cartilage is eroded causing arthritis between the navicular and the accessory navicular bones.


An accessory navicular often causes no symptoms and some people are even unaware they have this extra bone. Anyone who has an accessory navicular may feel pain from pressure against shoes.

Risk Factors

A family history of immediate family members having an accessory navicular bone increases the likelihood of having the problem. Pain from an accessory navicular is more likely for people who have a foot arch that is either flat or high. Pain may be caused from trauma to the area of the foot or overuse, such as from a long hike. Accessory navicular pain frequently flares up when wearing new shoes or a different style of shoes.


An accessory navicular is congenital, present at birth. It is estimated that 4-14% of the population is born with an accessory navicular bone which is the result of the navicular bone and the accessory navicular remaining connected by fibrous tissue or cartilage, but failing to fuse into one solid bone during maturation.


Treatment may start with anti-inflammatory drugs, physical therapy, altering the choice of footwear, or a below the knee walking cast. Orthotic devices are often useful in treating the syndrome. If these do not relieve the symptoms, a surgical option may be recommended.

The Concierge Podiatry Advantage

At Concierge Podiatry we often prescribe Perfect Posture Orthotics, which provide full contact support, relieving stress around the accessory navicular. Laser therapy can be used to decrease inflammation. We take the time needed to diagnose and explain any treatment options before beginning any course of treatment.

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