Yes, when symptomatic, an accessory navicular can indeed be a source of pain and disability. While it is an extra bone or cartilage that some people are born with and often causes no problems, its presence can lead to significant discomfort and functional limitations if it becomes symptomatic.
Understanding Accessory Navicular
The accessory navicular is an extra bone or piece of cartilage located on the inner side of the foot, near the arch, just above the main navicular bone. It is embedded in the posterior tibial tendon, which plays a crucial role in supporting the arch of the foot during movement.
Most individuals with an accessory navicular are unaware of its presence as it often remains asymptomatic. However, it can become symptomatic due to:
- Trauma: An ankle sprain or direct injury to the area.
- Irritation: Repetitive friction from footwear.
- Overuse: Chronic strain on the posterior tibial tendon.
When Accessory Navicular Leads to Disability
The term "disability" in this context refers to a limitation in a person's ability to perform daily activities or specific movements due to pain and functional impairment. When an accessory navicular becomes symptomatic, it can cause:
- Pain: Often a throbbing or aching pain on the inside of the midfoot, especially during or after activity.
- Swelling and Redness: Inflammation around the accessory navicular bone.
- Tenderness: The area becomes tender to the touch.
- Difficulty with Weight-Bearing: Pain can worsen with standing, walking, or running.
- Limited Mobility: The pain can restrict the range of motion of the foot and ankle.
This pain and dysfunction can hinder participation in various activities, ranging from simple daily tasks to demanding physical pursuits.
| Characteristic | Asymptomatic Accessory Navicular | Symptomatic Accessory Navicular |
|---|---|---|
| Pain | None | Present, often on inner midfoot |
| Function | No limitation | May cause disability, limiting activities |
| Inflammation | None | Swelling, redness, tenderness may be present |
| Treatment | Not required | May require conservative or surgical intervention |
Specific Considerations for Active Individuals
For individuals who place high demands on their feet, such as dancers or athletes, a symptomatic accessory navicular can pose even greater challenges, leading to a more pronounced sense of disability in their specific activities. The reasons for this increased impact include:
- Increased Demands on the Foot: Activities like dancing involve complex and strenuous foot movements, requiring significant strength and flexibility from the arch and supporting tendons.
- Repetitive Movements: The repetitive nature of many athletic and artistic movements can exacerbate irritation and inflammation of the accessory navicular and the posterior tibial tendon.
- Specific Footwear Requirements: Certain athletic or dance footwear may put additional pressure on the accessory navicular area, contributing to pain and discomfort.
Therefore, for these individuals, the condition can severely impact their ability to train, perform, or compete, effectively creating a disability in their professional or recreational pursuits.
Management and Outlook
Managing a symptomatic accessory navicular typically begins with conservative treatments aimed at reducing pain and inflammation. These may include:
- Rest and activity modification.
- Ice application.
- Anti-inflammatory medications.
- Custom orthotics or shoe inserts to support the arch.
- Physical therapy to strengthen the foot and ankle muscles.
In cases where conservative measures fail to alleviate symptoms and the condition continues to cause significant pain and disability, surgical removal of the accessory navicular bone may be considered. With appropriate management, many individuals can find relief from their symptoms and regain full function.
