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If the Inner Side of Your Foot Constantly Hurts and Feels Protruded: For Accessory Navicular Syndrome, Accurate Diagnosis Comes First

If you can feel a bone protruding below the inner ankle bone and that specific area feels particularly painful after walking or standing for a long time, you may need to suspect Accessory Navicular Syndrome. Many people dismiss this as simple foot fatigue or pain caused by ill-fitting shoes, but leaving it neglected can lead to worsening pain and significant disruption to daily life and exercise.

The accessory navicular is a small extra bone located next to the navicular bone of the foot, found in approximately 10 to 15% of the population. While it is a bone present from birth, most people live without any particular symptoms until pain begins to appear at a certain point. Symptoms often become prominent in growing adolescents or active young adults. It is also common for symptoms to start suddenly after a trauma, such as an ankle sprain, or to worsen as the area becomes irritated by friction from hard shoes.

The most characteristic symptom of Accessory Navicular Syndrome is pain and tenderness at the protrusion on the inner side of the foot. When walking or standing for a long time, or after exercise, the inner foot may throb, and the area may swell or turn red. In cases where flat feet are also present, the arch of the foot collapses, concentrating more stress on the accessory navicular area and potentially worsening the symptoms. Even if symptoms appear similar, the cause and severity can vary, making an accurate diagnosis more important than anything else.

Director Hong-Joon Choi of Seoul Gunwoo Orthopedic Clinic, located near Gangil Station in Gangdong-gu, Seoul, emphasizes, "The presence of the accessory navicular itself is not the problem; the core cause of pain is the irritation and inflammation of the tissues surrounding that bone. If inner foot pain repeats, do not pass it off as simple fatigue, but confirm the cause through accurate imaging tests."

Seoul Gunwoo Orthopedic Clinic precisely evaluates the location and size of the accessory navicular and the degree of damage to surrounding tissues through X-ray and MRI scans. The clinic's medical principle is to review the test results with the patient, providing a full explanation so that the patient can accurately understand their own foot condition before deciding on a treatment direction together.

If symptoms are not severe, non-surgical treatment is attempted first. Customized insoles or braces are used to support the arch of the foot and reduce irritation to the accessory navicular area, while medication, physical therapy, and extracorporeal shock wave therapy are combined to manage pain and inflammation. Fixed treatment for a certain period may be necessary during the acute phase. However, if symptoms persist despite conservative treatment or if pain is severe enough to interfere with daily life and exercise, surgical treatment is considered. Surgery involves removing the extra bone and reattaching the posterior tibial tendon, with the goal of restoring the structural stability of the foot.

Director Choi explains, "The most important thing in treating Accessory Navicular Syndrome is to accurately design a treatment direction that fits the severity of the symptoms and the patient's lifestyle. Rather than rushing into surgery, it is key to first judge whether conservative treatment is sufficient and, if surgery is necessary, to systematically manage post-operative rehabilitation for a full recovery."

After surgery, a process of regaining the strength and flexibility of the foot and restoring normal walking function through a step-by-step rehabilitation program is essential. Seoul Gunwoo Orthopedic Clinic takes responsibility for the entire process through systematic rehabilitation management so that patients can safely return to their daily lives after surgery.

If inner foot pain repeats or the protruding area concerns you, please do not regard it as mere discomfort and receive an accurate diagnosis. Director Hong-Joon Choi of Seoul Gunwoo Orthopedic Clinic holds a Ph.D. from Korea University and is a foot and ankle specialist who served as an exchange professor at the Foot and Ankle Center of Massachusetts General Hospital (MGH), affiliated with Harvard Medical School. Based on his rich clinical experience of treating over 80,000 foot and ankle patients and performing approximately 9,000 surgeries, he is dedicated to the diagnosis and treatment of all foot and ankle disorders, including hallux valgus, ankle ligament and cartilage damage, plantar fasciitis, Achilles tendonitis, ankle arthritis, Morton's neuroma, and tailor's bunion. Please receive an accurate diagnosis and customized treatment at Seoul Gunwoo Orthopedic Clinic, which does its best for the foot health of patients in the Gangdong, Hanam, and Misa areas.

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