Quick answer: Accessory Navicular Syndrome Medial Foot Pain Adolescents Michigan has multiple potential causes including mechanical, neurological, vascular, and inflammatory. The patterns we see most often are overuse, poorly-fitted shoes, and biomechanical imbalance. Red flags requiring urgent evaluation: warmth/redness (infection), inability to bear weight (fracture), and unilateral swelling without injury (DVT). Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM · Board-Certified Podiatric Surgeon · Last reviewed: April 2026 · Editorial Policy
The most important clinical decision with Accessory Navicular Syndrome Medial Foot Pain Adolescents Michigan isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Quick Answer
Accessory Navicular Syndrome — Medial Arch Pain in Ado relates to foot pain — typically caused by overuse, footwear, or biomechanics. Most patients improve in 6-12 weeks with conservative care. Same-week appointments in Howell + Bloomfield Hills: (810) 206-1402.
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What Is an Accessory Navicular?
An accessory navicular is an extra bone (os naviculare) located on the inner side of the foot, adjacent to the navicular bone at the medial arch. It is present in approximately 4–14% of the population as a normal anatomical variant — most people with an accessory navicular have no symptoms throughout their life. However, in approximately 1 in 3 carriers, the accessory navicular becomes symptomatic during adolescence (typically age 8–15, coinciding with growth plate activity) or in adulthood after trauma or repeated stress. Symptomatic accessory navicular syndrome is one of the most common causes of medial arch pain and flatfoot in adolescents. At Balance Foot & Ankle in Howell and Bloomfield Hills, Michigan, Dr. Tom Biernacki, DPM evaluates and treats accessory navicular syndrome. Call (810) 206-1402.
Why the Accessory Navicular Becomes Painful
The accessory navicular is the attachment site of the posterior tibial tendon — the primary arch-supporting tendon of the foot. The posterior tibial tendon transmits significant tensile force through the accessory navicular with every step. Three accessory navicular subtypes exist with different symptom patterns: Type I — a small sesamoid bone in the posterior tibial tendon, rarely symptomatic; Type II — connected to the navicular by a cartilaginous synchondrosis (fibrocartilage bridge) — the most common symptomatic type, where repetitive stress creates micromotion and inflammation at the fibrocartilage junction; Type III — fully fused to the navicular (cornuate navicular), typically asymptomatic. Type II accessory navicular produces pain because the fibrocartilage synchondrosis acts like a stress fracture site under repetitive posterior tibial tendon loading — inflaming and developing stress edema visible on MRI.
Symptoms and Diagnosis
Accessory navicular syndrome presents with: a visible bony prominence on the inner side of the foot at the medial navicular area; tenderness directly over the bony prominence with direct pressure (shoe pressure); pain with standing, walking, or running activities; and frequently, a flatfoot deformity on the same side (the accessory navicular alters the posterior tibial tendon’s mechanical advantage). X-ray confirms the presence and type of the accessory navicular on oblique foot views. MRI is the most sensitive diagnostic tool — it shows bone marrow edema at the synchondrosis junction, confirming the Type II accessory navicular is actively stress-loaded and symptomatic rather than incidental.
Conservative Management
Conservative treatment of accessory navicular syndrome succeeds in 70–89% of patients when implemented consistently: short-leg cast or cam boot immobilization for 4–6 weeks to rest the synchondrosis and reduce bone marrow edema; custom orthotics with a medial arch post and navicular pad that offloads direct pressure on the prominence while providing arch support; activity modification — reducing high-impact loading during growth plate activity; and anti-inflammatory management. The critical element: orthotics must be worn in all footwear including athletic shoes, not just dress shoes. Custom medial arch support significantly reduces posterior tibial tendon pull on the accessory navicular during ambulation.
Surgical Management — Kidner Procedure
When conservative management fails after 3–6 months, surgical excision of the accessory navicular (modified Kidner procedure) provides reliable pain relief: the accessory navicular is excised through a medial incision; the posterior tibial tendon is reattached or advanced to the native navicular in a more plantar position to improve its arch-supporting mechanical advantage; recovery 6–8 weeks non-weight-bearing, 3–4 months to full activity. Success rates exceed 85% in adolescents and 75% in adults. In patients with concurrent significant flatfoot, a flatfoot reconstruction (calcaneal osteotomy, posterior tibial tendon advancement) may be combined with the Kidner procedure for comprehensive correction.
Accessory Navicular Management in Howell & Bloomfield Hills Michigan
Dr. Tom Biernacki, DPM evaluates accessory navicular syndrome with clinical examination, weight-bearing X-rays, and MRI coordination at Balance Foot & Ankle. Custom medial arch orthotics are fabricated in-office. Surgical consultation is available when conservative management is insufficient. Serving Howell, Brighton, Bloomfield Hills, Troy, Auburn Hills, and all Southeast Michigan. Book your evaluation or call (810) 206-1402.
Dr. Tom’s Recommended Insoles
📍 Located in Michigan?
Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
PowerStep is the brand I prescribe most — medical-grade OTC support without the custom orthotic price tag.
- PowerStep Pinnacle Insoles — The OTC orthotic I recommend most — medical-grade arch support at a fraction of custom orthotic cost. Works in most shoes.
- PowerStep Maxx Insoles — For severe arch pain or flat feet — maximum correction and support when Pinnacle isn’t enough.
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we trust for our own patients.
👟 Dr. Tom’s Pick: CURREX RunPro Insoles for Runners
CURREX RunPro are biomechanically tuned running insoles with 3 arch profiles (low, medium, high) to match your foot type. Unlike generic insoles, they’re engineered specifically for the high-impact demands of running — reducing pronation stress and metatarsal loading.
View CURREX RunPro on Amazon →
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases.
💊 Dr. Tom’s Pick: Doctor Hoy’s Natural Pain Relief
A topical pain relief gel I recommend to patients: arnica, camphor, and natural anti-inflammatories. No prescription needed. Apply directly to the painful area for fast-acting relief. Great for sore feet, heel pain, and joint discomfort.
View Doctor Hoy’s on Amazon →
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases.
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Ready to Get Expert Foot Care?
Dr. Biernacki and our team at Balance Foot & Ankle are accepting new patients in Howell and Bloomfield Hills, MI. Most insurances accepted.
or call (810) 206-1402
Top Walking Shoes for Foot Health
- New Balance 928v3 — Therapeutic/Diabetic Walking Shoe
- Brooks Addiction Walker — Motion Control
- New Balance 840v5 — Everyday Walking
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Watch: How to Cure Plantar Fasciitis in One Week? [FAST Heel Pain Relief!] — MichiganFootDoctors YouTube
Max-cushion everyday shoe — podiatrist favorite for walking and running.
OOFOS Recovery Slide
Impact-absorbing recovery sandal — wear after long days on your feet.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Hills clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.
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.
| Condition | How It Differs |
|---|---|
| Posterior tibial tendon dysfunction | Pain along the tendon course with progressive flatfoot; may coexist. |
| Medial midfoot sprain | Ligamentous tenderness without a prominent bony bump. |
| Navicular stress fracture | Dorsal 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.
Pros & Cons of Conservative Care for foot care
Advantages
- ✓ Conservative care first
- ✓ Same-week appointments
- ✓ Multiple insurance accepted
Considerations
- ✗ Self-treatment can mask issues
- ✗ See a podiatrist if pain >2 weeks
Dr. Tom’s Recommended Products for foot care
Affiliate disclosure: As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. We only recommend products we use with patients.
Footnanny Heel Cream Dr. Tom’s Pick
Best for: Daily moisturizer for cracked heels
Ready to Get Back on Your Feet?
Same-day appointments in Howell + Bloomfield Hills. Most insurance accepted. Dr. Tom Biernacki, DPM & team.
Book Today — Same-Day Appointments Available
Call Now: (810) 206-1402
About Your Care Team at Balance Foot & Ankle
Dr. Tom Biernacki, DPM · Board-Certified Foot & Ankle Surgeon. Specializes in conservative-first care, minimally invasive bunion surgery, and complex reconstruction.
Dr. Carl Jay, DPM · Accepting new patients. Specializes in sports medicine, athletic injuries, and routine podiatric care.
Dr. Daria Gutkin, DPM, AACFAS · Accepting new patients. Specializes in surgical reconstruction and pediatric podiatry.
Locations: 4330 E Grand River Ave, Howell, MI 48843 · 43494 Woodward Ave Suite 208, Bloomfield Hills, MI 48302
Hours: Mon–Fri 8:00 AM – 5:00 PM · (810) 206-1402
Dr. Hoy’s Complete Pain Relief Line — Dr. Tom’s Picks (2026)
Dr. Hoy’s Natural Pain Relief is Dr. Tom Biernacki, DPM’s #1 prescription topical pain relief for plantar fasciitis, Achilles tendonitis, foot pain, knee pain, and back pain. Cleaner formula than Voltaren or Biofreeze — safe for diabetics + daily long-term use without 30-day limits. Below is the complete Dr. Hoy’s product line, organized by use case.
Dr. Hoy’s Natural Pain Relief Gel (4oz Tube)Dr. Tom’s #1 Brand
The flagship Dr. Hoy’s — menthol-based natural pain relief gel. The bottle Dr. Tom hands every plantar fasciitis patient on visit one. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief 5-10 min
- Daily long-term use safe
- Pricier than Biofreeze
- Strong menthol scent at first
Dr. Hoy’s Natural Pain Relief Gel (8oz Pump Bottle)Dr. Tom’s #1 Brand
8oz pump bottle — same formula as the 4oz tube but 2x the value. Best for athletes, families, or chronic pain patients who use it daily.
- 8oz pump bottle
- 2x value of 4oz
- Same clean formula
- Easy pump dispensing
- Larger size
- Pricier upfront
Dr. Hoy’s Arnica Boost Pain ReliefDr. Tom’s #1 Brand
Dr. Hoy’s + arnica boost — for bruising, swelling, post-injury inflammation. Adds arnica’s anti-inflammatory power to the standard menthol formula.
- Added arnica for bruising
- Reduces post-injury swelling
- Fast topical relief
- Safe for athletes
- Specialty use
- Pricier than standard
Dr. Hoy’s Natural Pain Relief Roll-OnDr. Tom’s #1 Brand
Same Dr. Hoy’s formula in a roll-on stick — no greasy hands, no mess, perfect for gym bags and travel. TSA-friendly.
- No greasy hands
- TSA-friendly
- Travel-sized
- Same Dr. Hoy’s formula
- Less product per use
- Pricier per oz
Dr. Hoy’s Pain Relief Gel — 3-Pack BundleDr. Tom’s #1 Brand
3-pack of Dr. Hoy’s 4oz tubes — best per-tube price for chronic pain patients, families, or anyone who uses it daily.
- 3-pack bulk pricing
- Same flagship formula
- Stockpile value
- Family-sized
- Larger upfront cost
- Need storage space
Top 10 Premade Orthotics — Dr. Tom’s Picks (2026)
Dr. Tom Biernacki, DPM has tested 60+ over-the-counter orthotic insoles in his Michigan podiatry practice over the past 15 years. Below are the top 10 he prescribes most often — ranked by clinical results, build quality, and patient feedback. PowerStep + CURREX brands are Dr. Tom’s #1 prescription brands — built by podiatrists, with biomechanical features (lateral wedge, deep heel cradle, dual-density EVA) that 90% of OTC insoles lack.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
The most prescribed OTC orthotic in podiatry. Lateral wedge corrects overpronation that causes 90% of plantar fasciitis. Deep heel cradle stabilizes the ankle.
- Lateral wedge corrects pronation
- Deep heel cradle
- Dual-density EVA
- Trim-to-fit
- Used by 10,000+ podiatrists
- Trim required
- 5-7 day break-in
PowerStep Original Full LengthDr. Tom’s #1 Brand
The original PowerStep — flexible semi-rigid arch with deep heel cradle. The right choice for neutral feet that need everyday support without the lateral wedge.
- Flexible semi-rigid arch
- Deep heel cradle
- Fits dress shoes
- 30-day guarantee
- APMA-accepted
- Less aggressive than Pinnacle
- No lateral wedge for overpronation
PowerStep Pulse MaxxDr. Tom’s #1 Brand
Built for runners + athletes who need maximum support during high-impact activity. Engineered for forefoot strike + lateral motion.
- Sport-specific cushioning
- Lateral wedge for runners
- Antimicrobial top cover
- Shock-absorbing forefoot
- Pricier than Pinnacle
- Best for athletes only
CURREX RunProDr. Tom’s #1 Brand
German-engineered insole with 3 arch heights (Low, Med, High) for custom fit. Carbon-reinforced heel + dynamic forefoot.
- 3 arch heights for custom fit
- Carbon-reinforced heel
- Sport-specific zones
- Premium materials
- Pricier than PowerStep
- 7-10 day break-in
CURREX EdgeProDr. Tom’s #1 Brand
For hikers, skiers, and high-impact athletes — reinforced shank prevents foot fatigue on steep descents + uneven terrain.
- Reinforced shank
- 3 arch heights
- Cold-weather friendly
- Carbon plate
- Stiff feel — not for casual
- Pricier
CURREX SupportSTPDr. Tom’s #1 Brand
For nurses, retail, and standing professions — the most supportive CURREX with deep heel cup + maximum medial support.
- Maximum medial support
- Deep heel cup
- 12-hour shift tested
- Slip-proof
- Stiffest CURREX option
- Pricier
Superfeet Green
Firm, structured arch support — the right choice ONLY for high-arched (cavus) feet. Wrong choice for flat feet.
- Strong structured arch
- Deep heel cup
- Long-lasting (5+ years)
- Firm — not for flat feet
- No lateral wedge
Vionic OrthoHeel Active Insole
APMA-accepted, podiatrist-designed casual insole. Best for adding mild arch support to dress shoes + walking shoes.
- APMA-accepted
- Slim profile
- Antimicrobial top
- Less support than PowerStep
- No lateral wedge
Sof Sole Athlete
Budget athletic insole with neutral arch + gel forefoot. Decent value if you need a quick replacement.
- Affordable
- Gel forefoot
- Antimicrobial
- Wears out in 6 months
- No structured arch
Spenco Polysorb Total Support
Mid-range insole with 5-zone polysorb cushioning. Decent support for standing professions.
- 5-zone cushioning
- Trim-to-fit
- Mid-price point
- Less stable than PowerStep
- No lateral wedge
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
- Deep heel cradle stabilizes ankle
- Dual-density EVA — comfort + support
- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
CURREX RunProDr. Tom’s #1 Brand
3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
- 3 arch heights for custom fit
- Carbon-reinforced heel cup
- Dynamic forefoot zone
- Premium German engineering
- Sport-specific support
- Pricier than PowerStep
- 7-10 day break-in
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
- Pricier than Biofreeze
- Strong menthol scent at first
When to See a Podiatrist for This Type of Pain
If your pain has lasted longer than 3-4 weeks despite home treatment, is interfering with daily activities, or includes redness, swelling, or warmth, it’s time to schedule an evaluation. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki and his team specialize in same-day diagnosis and conservative treatment plans tailored to your activity level and goals. Most patients are walking pain-free within 4-6 weeks of starting our protocol.
Red flags that warrant immediate care: sharp pain after a fall, inability to bear weight, visible deformity, numbness or tingling, fever with foot pain, or any open wound on a diabetic foot. Don’t wait — early treatment dramatically improves outcomes and prevents chronic complications.
Visit Balance Foot & Ankle — Same-Day Appointments Available
Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Hills. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.
Same-day appointments available. (810) 206-1402
Frequently Asked Questions
When should I see a doctor?
See a podiatrist if pain persists past 2 weeks, prevents normal activity, or is accompanied by red-flag symptoms (warmth, swelling, numbness, inability to bear weight).
Can I treat this at home?
Mild cases respond to RICE protocol (rest, ice, compression, elevation), supportive shoes, and OTC anti-inflammatories. Persistent symptoms need professional evaluation.
How long does it take to heal?
Most soft tissue injuries resolve in 2-6 weeks with appropriate care. Bone injuries take 6-12 weeks. Chronic conditions need longer-term management.
What is Foot pain?
Foot pain is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.
Symptoms and warning signs
Common signs of foot pain include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.
Conservative treatment options
Most cases of foot pain respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including MLS laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.
When is surgery considered?
Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.
Recovery timeline and prevention
Recovery from foot pain varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.
Ready to feel better?
Same-week appointments available in Howell and Bloomfield Hills, Michigan.
Book Your VisitOur podiatrists treat the underlying cause, not just the symptom. Same-week appointments at our Howell and Bloomfield Hills, Michigan offices.
Ready for Expert Care?
Same-day appointments in Howell & Bloomfield Hills, MI.
4.9★ | 1,123 Reviews | 3,000+ Surgeries
Or call: (810) 206-1402
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.