Accessory Navicular Bone: Surgery or Alternative Treatments? - Orthopedics

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The accessory navicular bone is a small extra bone located on the inner side of the foot, just above the arch. It is a congenital condition, meaning that individuals are born with it. While many people with an accessory navicular experience no symptoms, others may develop pain or discomfort, particularly if the bone becomes irritated or if there is associated tendonitis of the posterior tibial tendon.
When considering treatment options for symptomatic accessory navicular bone, there are generally two main approaches: conservative (non-surgical) treatments and surgical intervention.
Conservative Treatments:
1. Rest and Activity Modification: Reducing activities that exacerbate the pain can help alleviate symptoms. This might include avoiding high-impact sports or prolonged standing.

2. Orthotics: Custom orthotic devices can provide support to the foot and help redistribute pressure away from the accessory navicular. This can be particularly beneficial for individuals who have flat feet or overpronation.

3. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the foot and improve flexibility, which may reduce pain.

4. Medications: Over-the-counter pain relievers, such as NSAIDs (non-steroidal anti-inflammatory drugs), can help manage pain and inflammation.

5. Ice Therapy: Applying ice to the affected area can help reduce swelling and pain.

Surgical Treatment:
If conservative treatments fail to provide relief after a reasonable period (usually several months), surgical options may be considered. The most common surgical procedure for an accessory navicular is excision of the accessory bone. This procedure involves removing the accessory navicular and any associated inflamed tissue.
Indications for Surgery:
- Persistent pain that interferes with daily activities despite conservative treatment.

- Significant swelling or tenderness over the accessory navicular.

- Development of complications such as tendonitis or other structural issues in the foot.

Recovery and Outcomes:
Surgery can be effective in relieving pain and restoring function for many patients. However, as with any surgical procedure, there are risks involved, including infection, nerve damage, and complications related to anesthesia. Recovery typically involves a period of immobilization followed by rehabilitation to regain strength and mobility.

Disability Considerations:
Regarding the question of whether having an accessory navicular bone can qualify for a disability permit, it largely depends on the severity of symptoms and how they affect daily functioning. In the United States, disability permits are typically granted based on the extent to which a condition limits an individual's ability to perform major life activities. If the accessory navicular bone causes significant pain or functional limitations, it may be possible to apply for a disability permit. Documentation from healthcare providers detailing the condition and its impact on daily life will be necessary for such an application.

Conclusion:
In summary, the decision to pursue surgery for an accessory navicular bone should be made after careful consideration of the severity of symptoms and the effectiveness of conservative treatments. Many individuals find relief through non-surgical methods, while others may benefit from surgical intervention. Consulting with a foot and ankle specialist can provide personalized recommendations based on individual circumstances. If you are experiencing significant pain or functional limitations, it is essential to discuss all available options with your healthcare provider to determine the best course of action for your specific situation.