Accessory Navicular Bone: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats an accessory navicular bone?
An accessory navicular bone, an extra small bone near the arch of the foot that some people are born with, is treated by a podiatrist (foot doctor) or an orthopedic doctor (bones and joints). A physical medicine and rehabilitation doctor can also help with exercises and bracing. Many people never have symptoms, and treatment is only needed if the area becomes painful.
What is an accessory navicular bone?
An accessory navicular is an extra bone on the inner side of the foot, in the arch area. The arch is the curved middle part of the foot. The extra bone sits next to the navicular, a bone in the midfoot (the middle of the foot). Many bones start out as cartilage (soft, growing tissue), and this extra bone does too. X-rays can have a hard time showing it until it hardens into bone. There are three types of accessory navicular. The extra bone is found attached to the posterior tibial tendon. A tendon is a strong cord that joins muscle to bone. This tendon helps hold up the arch of the foot.
Symptoms
For most people, an accessory navicular never causes symptoms. Signs can include:
- A bump on the inner side of the foot, in the arch area.
- Pain in the midfoot and arch.
- Pain that gets worse with walking, running, or shoes that rub the area.
The bump often shows up in the teen years. That is when the extra bone hardens.
Causes and who gets it
The extra bone is present at birth. Before birth, a second bone-forming center can appear in the navicular. It leads to an extra bone beside the navicular. It can affect one foot or both feet. For some people, pain starts after an injury, like a twist, stumble, or fall. Pain can get worse with weight-bearing activities, like walking and running. Shoes rubbing the bump can also cause pain. Sometimes the extra bone is linked to a flat foot (pes planus), a low arch.
How doctors diagnose it
Doctors ask about your symptoms and examine your foot. They check the area for tenderness (soreness). They also look at the tendon and the alignment of the ankle and foot. X-rays (pictures of the bones) help make the diagnosis. These X-rays are taken while you stand. Sometimes an MRI may be needed. An MRI is a scan that shows soft parts, like tendons. It shows whether the tendon is involved.
Treatment
The first step is care without surgery. It can include:
- Rest from the activity that causes pain. As the pain improves, you can resume activities.
- A medial heel wedge (a pad for the inner heel), anti-inflammatory medicine, and physical therapy.
- A cast or walking boot for a short time if the area is very painful.
- For a minority of patients, an arch support or custom orthotic (a shoe insert made for your foot) can take some pressure off the extra bone and the tendon.
Surgery is needed in a minority of cases. It can be considered when pain keeps coming back or does not get better with these steps. The surgeon removes the extra bone. The tendon is then joined back to the navicular. Care without surgery often works. Patients typically do very well with both kinds of care. Sports can usually restart once symptoms improve or healing is done.
When to see a doctor
See a doctor if the bump hurts or the area is red or swollen. Get care right away if you have sudden, severe foot pain. Get care right away if foot pain starts after an injury and your foot is bruising or bleeding, or you cannot put weight on it. Also call if you have a fever or an open sore on your foot.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can examine a painful foot. They can order X-rays and refer you to a foot specialist when needed.
Common questions
Does an accessory navicular bone need treatment?
Not always. Many people have an accessory navicular bone with no symptoms and never need treatment. Treatment is usually only started if the area becomes painful or swollen, often after an ankle injury or repeated activity.
Can a direct primary care doctor manage an accessory navicular bone?
A direct primary care doctor can examine a painful foot and order an X-ray to check for this extra bone, then refer you to a podiatrist or orthopedic doctor if ongoing treatment or bracing is needed.
What are the symptoms of an accessory navicular bone?
Symptoms can include pain, swelling, or a visible bump on the inner side of the foot near the arch, especially after activity. Many people have no symptoms at all and only find out about it on an X-ray.
Sources
- American Academy of Orthopaedic Surgeons - What Is an Accessory Navicular
- NCBI Bookshelf - Anatomy, Bony Pelvis and Lower Limb: Navicular Bone
- MedlinePlus Medical Encyclopedia - Foot pain
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
