An accessory navicular is an extra bone fragment or bit of cartilage material in the arch of the foot that might or may not result in issues. It's also often called an os navicularum or os tibiale externum. It is integrated within the tendon of the posterior tibial muscle that attaches in the region. The excess bone is on the inside side of the navicular bone which is the bone that is near the top of the arch of the foot. It takes place in between 5-15% of people. It is not often a problem, but the prominence of the accessory bone could make stress from the shoes painful. In some cases the accessory bone is at such a place that it does impact the angle of pull of the posterior tibial muscle that might impact foot function and may trigger a variety of biomechanical issues, such as a flat foot.
The diagnosis is frequently by a x-ray where the existence of the extra bone is clear. There are several varieties which the x-ray can help determine which one it is. The Geist grouping breaks the accessory navicular bones in to three different kinds. Each of the 3 types impacts the structure and function in the foot in different ways and each of the three different types will need a unique treatment approach.
The objective of treatment is to alleviate the symptoms preventing it getting painful. When the pain is especially bad, then placing the foot in a plaster cast or replaceable walking splint will permit the affected region to rest and help the pain. Ice could also be used to relieve inflammation. By mouth nonsteroidal anti-inflammatory drugs (NSAIDs) works extremely well in conjunction with immobilization to help lower the pain and swelling. Physical exercises and therapies to strengthen the muscles might be advised, in particular in the long run that will help avert a recurrence in the symptoms. Foot orthotic inserts are usually also very useful to protect the foot and become especially useful in the event the accessory navicular is bringing about a flat foot.
The accessory navicular can be quite a particular concern is sports for example skiing as well as ice skating. It is because the footwear in these sports goes around the foot and it is quite rigid. Therefore, if someone has a acessory bit of bone on the foot, such as an accessory navicular, this could be really painful and in addition difficult to treat. Items like donut type padding to deflect the force coming from the footwear away from the spot is oftentimes very helpful. This is also where the proficiency of a boot maker or a qualified ski boot fitter might be invaluable. These experts are used to handling these kinds of complications and can alter the footwear around the prominent bone making it more at ease. A podiatrist can frequently assist with all this.
In the event the traditional nonsurgical therapies don't minimize the pain, then surgical procedures could be suitable. Surgical procedures may involve getting rid of the accessory bone, re-shaping the area and repairing the tendon insertion to enhance its function. This accessory bone is just not required for normal foot function, and so in theory it will not be a problem.