Os Trigonum Syndrome

Os Trigonum Syndrome is a painful condition that occurs when a small extra bone—called the os trigonum—becomes irritated or compressed at the back of the ankle. This accessory bone is present in a portion of the population and typically causes no symptoms. However, with repeated pointing of the foot, forceful plantarflexion, or activities that place stress on the back of the ankle, the os trigonum and surrounding soft tissues can become inflamed.

This condition is especially common in dancers, runners, soccer players, and individuals whose work or athletic routines require frequent downward motion of the foot. Patients often describe deep, aching pain at the back of the ankle, swelling, or sharp discomfort when pushing off the toes, wearing certain shoes, or rising onto the balls of the feet.

At New Orleans Podiatry, your evaluation includes a detailed clinical examination and imaging to confirm the presence of an os trigonum and determine whether it is the source of your symptoms. We also assess for contributing factors such as tendon irritation, joint impingement, or calf muscle tightness, which may amplify the problem.

Treatment is tailored to reduce inflammation, restore motion, and prevent recurrent irritation. Care may include activity modification, targeted stretching, immobilization, anti-inflammatory protocols, Class IV laser therapy, and precise guidance on footwear or bracing. For cases involving significant inflammation or persistent symptoms, advanced injection therapy may be considered to calm the surrounding tissues and accelerate recovery.

When conservative care does not provide lasting relief and the os trigonum continues to cause impingement, surgical removal of the accessory bone may be recommended. Dr. Lang performs this procedure with meticulous technique—often using minimally invasive approaches when appropriate—to relieve pressure, protect surrounding structures, and allow for a smooth return to activity.

With accurate diagnosis and thoughtful treatment, most patients experience significant improvement in comfort and mobility, allowing them to return to the activities they love without chronic ankle pain.