Foot & toes
Painful accessory navicular
An extra bone near the inner arch: support, tendon assessment and options when pain persists.
Understanding the condition
An accessory navicular is an extra bone beside the navicular on the inner side of the foot. Many people have no symptoms. Pain can occur at the prominence or where the tibialis posterior tendon attaches. Assessment checks footwear pressure, tendon function and foot alignment; X-rays usually show the bone.
Treatment options
Supportive footwear, insoles, activity changes, physiotherapy and suitable pain relief may help. A short period in a boot may be considered for a painful flare. Surgery is discussed only if symptoms remain troublesome despite appropriate conservative care.
What a procedure may involve
The painful accessory bone may be removed and the tendon repaired or reattached to the main navicular. A significant flatfoot deformity may require additional correction. Not every extra bone is the source of pain, so the diagnosis and proposed procedure should be clear.
Risks and benefits to discuss
The intended benefits are less pain and easier footwear. Risks include persistent arch pain, tendon weakness or failure, altered alignment, wound or nerve problems, infection, blood clots and further surgery. Additional bone correction brings its own healing risks.
Any operation also carries bleeding and anaesthetic risks. Occasionally, complex regional pain syndrome causes prolonged pain and sensitivity. Your health and the extent of surgery change your personal risk.
Rehabilitation and aftercare
A tendon repair needs protection in a cast or boot. Keep wounds dry and follow your individual loading and movement limits; do not start strengthening simply because the skin has healed. Rehabilitation gradually restores walking, tendon strength and activity tolerance.
Expected outcomes and recovery
Conservative treatment can be effective. After surgery, swelling and tendon recovery may take months, and some discomfort can persist. Return to sport depends on healing and functional strength rather than the disappearance of the bony bump alone.
When to seek urgent help
Seek prompt advice for rapidly increasing pain, spreading redness, wound discharge, fever, new numbness or a cast or boot causing pressure. New calf pain or swelling needs urgent assessment. Chest pain or breathlessness needs emergency help: call 999.
Your consent discussion
Ask which treatment best addresses your symptoms, what alternatives are reasonable, what the main risks mean for you, and what recovery will involve at home and work. This guide supports that discussion; consent is completed with your treating team. Your individual written instructions take priority.
Your consent discussion
Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.
Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.
Further reading & sources
Prepared 10 October 2026 for the practice of Mr Peyman Bakhshayesh. Professional background. General patient education; your clinical assessment and written instructions determine your care.
Private care in Huddersfield
Let’s talk about your next step.
Arrange an appointment to discuss your concerns and the options available to you.