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Cuboid syndrome is a medical condition caused when the cuboid bone moves out of alignment. The cuboid bone is part of a joint that helps to maintain foot mobility when walking. Cuboid syndrome is thought to be a common source of lateral midfoot pain in athletes.
The prevalence of cuboid syndrome is unclear. Approximately 4% of athletes with foot injuries have symptoms originating from the cuboid bone. Cuboid syndrome is found in 17% of professional ballet dancers with foot or ankle injuries and 6.7% of patients with plantar flexion or inversion ankle sprains.
Causes
It is most often the result of injury or trauma to the joint between heel bone and the cuboid bone, and/or ligaments surrounding it. Several causes have been proposed for cuboid syndrome, including excessive pronation, overuse, and inversion ankle sprains; however, the exact pathological mechanism is unknown. Most people who suffer cuboid syndrome have flat feet, although the condition can even occur in people with very high arches.
Symptoms
The pain from cuboid syndrome can range from minor discomfort to quite severe and disabling.
- -The patient usually describes the sensation that the foot needs to “pop”.
- There is discomfort and pain on the outer side, and possibly underside, of the foot.
- Patients describe pain mostly around the centre of the foot and close to the base of the fourth and fifth toes.
- It might resemble the symptoms of a ligament sprain.
- There is immediate foot pain, often worse on standing or walking on the foot.
Risk Factors for Developing Cuboid Syndrome might include:
- Tight Achilles tendon/ weakness in the leg muscles
- Non-supportive shoes.
- Increased body mass index (being overweight).
- Working or walking on uneven surfaces.
Examination
Cuboid syndrome is a relatively common, painful condition of the lateral midfoot that can be difficult to recognize because there are no definitive diagnostic procedures/ tests for this condition. Imaging is of very little value. You would benefit from a visit to a healthcare professional as the diagnosis is usually based on the patient’s history and the presence of signs and symptoms. There are some manoeuvers/ tests carried out by physiotherapists/ podiatrists that may further help determine this condition.
Cuboid syndrome may often be misdiagnosed as a lateral ankle sprain or overlooked when it develops in conjunction with a lateral ankle injury. Persistent pain in the outside of the foot, after the symptoms of ankle sprain subside, should raise a concern. It is advisable to come visit a healthcare facility and get your foot and ankle seen to avoid any misdiagnosis.
Treatment
It is suggested that the cuboid syndrome often responds favorably to manipulation and/or external support. Seek the guidance of an expert physiotherapist that knows cuboid manipulation that might help reduce pain. Following successful manipulation, recurrence may be prevented by stretching and strengthening, employing taping, orthoses, and/or cuboid padding. Podiatrist can help determine your gait and further need of insoles to prevent excessive pronation that may prevent a recurrence of cuboid syndrome.
There is little to no evidence to suggest that surgery might help with cuboid syndrome.
You may want to seek physiotherapy depending on the duration of your cuboid pain that might be accompanied by other ankle injuries. It might be wise to have a team of medical healthcare professionals to help improve pain and function, quality of life and return to an active lifestyle.
