How would i be able to tell when i need to have surgery for my accessory navicular bone?

Pain: When you have excessive pain at the area or deformity that leads to pain or instability. Usually the posterior tibia tendon can maintain your arch and stability, but in cases where the accessory navicular is prominent and painful against normal shoegear, accomodations can be given. When exhaustive nonsurgical care is finished, then surgery is recommended.