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Accessory Navicular: The Extra Bone That Causes Arch Pain

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.

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More Podiatrist-Recommended Plantar Fasciitis Essentials

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Keeps fascia stretched overnight — the #1 intervention for morning heel pain.

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Deep heel cup + arch support unloads the plantar fascia all day.

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Accessory Navicular Ap Anatomy - Balance Foot & Ankle

When to See a Podiatrist

If morning heel pain has persisted more than 6 weeks, home care alone rarely fixes it. At Balance Foot & Ankle, we combine in-office ultrasound diagnostics, custom orthotics, and — when needed — shockwave or PRP to resolve plantar fasciitis that hasn’t responded to stretching and inserts. Most patients are walking pain-free within 4-8 weeks of starting a structured plan.

Call Balance Foot & Ankle: (810) 206-1402  ·  Book online  ·  Offices in Howell & Bloomfield Hills

Differential Diagnosis: What Else Could It Be?

Not every case of accessory navicular syndrome is straightforward. In our clinic we routinely rule out three look-alike conditions before confirming the diagnosis. If your symptoms don’t match the classic presentation, one of these may explain the pain — which is why physical exam matters more than self-diagnosis.

ConditionHow It Differs
Posterior tibial tendon dysfunctionPain along the tendon course with progressive flatfoot; may coexist.
Medial midfoot sprainLigamentous tenderness without a prominent bony bump.
Navicular stress fractureDorsal midfoot pain with impact; confirmed on MRI, not an accessory bone.

Red Flags — When to See a Podiatrist Now

Seek same-day evaluation at Balance Foot & Ankle if you notice any of the following:

  • Visible bony bump on the medial midfoot with redness
  • Collapsing arch in a child or adolescent
  • Pain preventing participation in sport
  • Failed 6 weeks of orthotic and activity modification

Call (810) 206-1402 or request an appointment. Our Howell and Bloomfield Hills offices reserve same-day slots for urgent foot and ankle issues.

In Our Clinic: What We See

Clinical perspective from Dr. Tom Biernacki, DPM — Balance Foot & Ankle, Howell & Bloomfield Hills, MI:

Accessory navicular syndrome shows up in active adolescents and sometimes adults with a visible medial bump. In our clinic the exam finding is tenderness directly over the ossicle and pain with resisted inversion. X-rays confirm the accessory bone; MRI shows whether the ossicle is inflamed. Most patients respond to custom orthotics, activity modification, and short-term boot immobilization over 6-12 weeks. When conservative care fails, a Kidner procedure — excising the ossicle and re-attaching the posterior tibial tendon — restores arch function. Dr. Biernacki counsels families to try orthotics for 6 weeks first; surgery when needed is predictable but usually preventable.

Recommended Products for Flat Feet
Products personally used and recommended by Dr. Tom Biernacki, DPM. All available on Amazon.
Structured arch support that provides the structure flat feet are missing.
Best for: All shoe types
Dynamic arch support designed for runners with flat or low arches.
Best for: Running, high-impact sports
These products work best with professional treatment. Book an appointment with Dr. Tom for a personalized treatment plan.
Medical References
  1. Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
  2. Plantar Fasciitis (APMA)
  3. Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
  4. Heel Pain (APMA)
This article has been reviewed for medical accuracy by Dr. Tom Biernacki, DPM. References are provided for informational purposes.

Recommended Products from Dr. Tom

Balance Foot & Ankle surgeons are affiliated with Trinity Health Michigan, Corewell Health, and Henry Ford Health — three of Michigan’s largest health systems.
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