Skip to main content
Foot & Ankle

Navicular Bone Pain: Causes and Treatment

By Last updated on April 17th, 2023April 17th, 2023No Comments

The human foot consists of 26 bones. The navicular bone is one of them, connecting the ankle to the midfoot and forefoot bones. It plays a significant role in forming the arch that supports walking. 

Unfortunately, the navicular bone is susceptible to fractures for various reasons. This problem is quite common in athletes as they kick, sprint, twist, and fall almost daily. Some other factors include irritation of nerves, ligament injuries, and Accessory navicular syndrome. 

You’re likely to experience navicular bone pain in your entire foot, especially the midfoot. Luckily, the condition can be easily treated through some conventional and orthobiologic methods. 

The Anatomy of the Navicular Bone

The Anatomy of the Navicular Bone

The navicular bone is a tiny C-shaped bone in the inside region of your midfoot. It lies between the talus and the three cuneiform bones, forming the midfoot and forefoot. This structural link between these crucial bones supports the foot and arch when walking, sprinting, or running. The navicular bone consists of only muscle, the Tibialis posterior muscle. 

The 26 bones in our foot are connected through ligaments and muscles. Ligaments are thick connective tissue bands that hold one bone to the other. For instance, the spring ligament connects the navicular bone to the heel bone, strengthening the arch and foot. 

6 Causes of Navicular Bone Pain

Many factors can cause navicular bone pain, including:


Navicular fractures are common due to trauma, stress, or chronic overuse. They account for about 14 to 35% of all types of foot stress fractures. The symptoms include extreme pain, limited motion range, and swelling. 

If you feel a sudden pain in your midfoot, immediately get it CT scanned for the diagnosis. Simple X-rays may not detect the navicular fractures easily. 


Osteoarthritis is the natural tearing down of cartilage, which protects bone joints and supports the smooth movement. This condition damages the cartilage in your feet gradually, causing more pain over time. 

Navicular osteoarthritis is caused due to trauma and bone degeneration. As a result, you’ll feel extreme pain when standing and walking for a long time. 

Kohler Disease

Kohler disease is an osteonecrosis condition in which the bone tissue dies from a lack of blood supply required for optimum health. It is a common condition in children, especially in males. 

Children around three years of age have calcified navicular bone. As they grow, their weight increases, and so does the compression in the feet by other bones. When this compression is accompanied by zero blood supply to the navicular bone, the chances of Kohler disease and pain increase.

The symptoms include pain, tenderness, and swelling in the midfoot.

Ligament Injuries

Ligaments are the essential part of your foot, providing stability to all the bones and muscles. Any injury to ligaments can affect your activity, leading to an unstable arch and foot. This instability results in excessive or unusual movements of the bones, which causes arthritis, degeneration, and tendonitis. 

Nerve Injury in the Lower Back

The lower back nerves send electrical signals to different muscles in our body, primarily the feet, legs, and ankle. This enables smooth muscle contraction and relaxation, ensuring full muscle strength. 

Muscle strength is essential to keep the feet stable. However, many factors can compromise the nerves’ electrical signals, including herniation, disc bulges, and slips. These conditions can cause severe foot pain and instability. 

Accessory Navicular Syndrome

The navicular bone has an additional piece of bone attached called the accessory navicular bone. It is rare, present only in 4 to 14% of the world population. The accessory navicular bone is located on the inner side of the navicular bone. 

Accessory navicular syndrome happens when the accessory bone causes pain after a trauma or friction. It is mainly identified by swelling and pain.

Treatment for Navicular Bone Pain

The best treatment for navicular bone pain varies depending on its cause and intensity. Your doctor will first analyze your situation and suggest the right option. Typically, they will opt for conventional treatments and then move on to orthobiologic treatments. 

Conventional Methods

The first-hand treatment for navicular bone pain includes:

  • Rest. Immobilization, elevation, and rest release the stress on the navicular bone and improve ligament instability. Your doctor will also recommend that you stop bearing weights. 
  • Activity Modification and Physical Therapy. In the case of osteoarthritis and accessory navicular syndrome, you’ll have to opt for conservative care, such as activity modification and physical therapy. These will help restore immobility, muscle strength, and ligament instability.
  • Custom Orthotic Device. The device can be a shoe insert put inside the shoe to support the foot arch.
  • Oral Medications. As the first-line treatment, your doctor will prescribe you a few oral medications or supplements, such as fish oil or turmeric. If the pain persists, they may suggest you take safe anti-inflammatory drugs.
  • Surgery. The surgical options include removing accessory navicular bone, fusion and joint replacement, and joining the ligament ends.

Orthobiologic Methods

With regenerative medicine advancements, orthobiologic treatments have become more popular for treating different bone pains. They primarily include cell-based therapies and platelet-rich plasma (PRP) therapy, focusing on replacing the damaged tissues with the patient’s “autologous” or own cells.

At CELLAXYS, we offer both types of orthobiologic treatments:

  • Cell-Based Therapies. This process takes out healthy tissues from the patient, concentrates them, and replaces them with the damaged tissues of their navicular bone. Depending on your condition, the doctor may harvest cells from your adipose (fat) tissue, called Minimally Manipulated Adipose Tissue (MMAT) transplant, or from your bone marrow, called Bone Marrow Concentrate (BMAC). 
  • Platelet-Rich Plasma (PRP) Therapy. This process isolates platelets (healing components) from the patient’s blood plasma, concentrates them, and reinjects them in the injury site. Platelets perform three functions. They release 10 Growth Factors, send chemical signals to attract healing cells, and produce a sticky scaffolding called fibrin. All these things boost the growth and development of new tissues and promote healing. 

Cell-based or stem cell therapies take about 1.5 to 2 hours to complete, while PRP takes about 45 minutes. Both are outpatient procedures, meaning you can go home right after the process. The doctor will use X-rays (fluoroscopy) or live ultrasounds to identify the injury’s location.

Dr. Matthew HC Otten

Director of Regenerative Orthopedic and Sports Medicine
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan State University Alumni


View Our Treatments