Medial Arch Pain

About 10-15% of people have an extra bone or piece of cartilage located on the inner side of the foot just above the arch, which is incorporated within the posterior tibial tendon attached in this area.  Some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated.  This can result from trauma as a foot strain, chronic irritation from shoes, and excessive activity or overuse.  Many people with accessory navicular syndrome also have flat feet. Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.

Nonsurgical Treatment for Medial Arch Pain：

• Immobilization: placing the foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation.

• Ice: to reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin.

• Physical therapy: physical therapy may be prescribed, including foot exercises to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms.

• Orthotic devices: custom orthotic devices that fit into the shoe provide support for the arch and may play a role in preventing future symptoms.

• Medications: oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation.

If nonsurgical treatment fails to relieve the symptoms of accessory navicular syndrome, surgery may be appropriate. Surgery may involve removing the accessory bone, reshaping the area and repairing the posterior tibial tendon to improve its function.