Foot injuries can happen to anyone, particularly those who are physically active and engage in sports, keep fit, running and even walking. Cuboid syndrome may not be the most familiar foot injury, but it is still common throughout the population although it is not particularly well defined, and can commonly evade diagnosis. The condition is known by a number of different names, including cuboid subluxation, cuboid fault syndrome, dropped or locked cuboid, or lateral plantar neuritis due to it commonly causing side of foot pain.
Cuboid syndrome is due to a fault with the cuboid bone or its articulation with the heel bone. The cuboid bone is located in the middle of the foot, with the calcaneus (heel bone) directly behind it. The condition stems from an injury to the joint and/or ligaments, and may involve subluxation, a term used to describe a partial dislocation or collapse of the joint.
Cuboid Syndrome disrupts the normal function of the calcaneocuboid joint, and can make movement difficult and usually causes pain during activity. There is also commonly weakness in the foot, it can become easily fatigued, and if not an intense pain, there can be persistent discomfort.
How does cuboid syndrome affect the joints?
The calcaneocuboid joint is located just below, and to the front of the ankle. The calcaneocuboid joint along with the talonavicular and subtalar joints are responsible for bearing weight to the forefoot. The process of load transfer through these bones and joints makes running, walking and dancing possible and gives great mobility to the foot.
Cuboid syndrome basically affects the lateral or outside part of the foot, where the calcaneocuboid joint is located. This part of the foot is primarily the load carrier which transfers the load from the heel to the forefoot. For people with this problem, the calcaneocuboid joint will not be able to bear the load that is placed unto it effectively and cause quite intense pain.
What causes cuboid syndrome?
Cuboid syndrome develops in the calcaneocuboid joint which is thought to be caused by an injury or a continuous strain to the joint. This type of syndrome usually affects athletes who are involved in sports and intensive training, especially those activities where excess pressure is exerted on the foot, and in particular through lateral movement, such as occurs in basketball, soccer, martial arts and gymnastics.
Other causes can be due to an individual’s specific anatomy or walking gait, with those pone to overpronate when walking and running, or through rigidity in the feet caused by underpronation or supination.
What are the symptoms of cuboid syndrome?
When there is pressure acting on the calcaneocuboid joint or its nearby structures, a person with cuboid syndrome will usually feel pain specifically in the lateral side of the foot. The pain is intermittent; it disappears and can return seemingly at random. The pain is aggravated when load is applied to the foot, and intensifies even more during toe off phase of the stride. The level of pain can be mild, moderate or debilitating, making high impact exercise all but impossible.
How is cuboid syndrome diagnosed?
Careful diagnosis needs to be undertaken if you have the symptoms of cuboid syndrome, and diagnosis may need to be made by a specialist or osteopath. Despite the problem being common, it is not often diagnosed and can be easily misinterpreted. Sometimes, when the extent of the damage is severe, pain may be referred to other areas such as the calf. As such, it is important to obtain a diagnosis using imaging tests such as X-rays and Magnetic Resonance Imaging (MRI) to accurately diagnose the condition. After an accurate diagnosis is made, a treatment plan can be developed to manage the condition.
What are the treatment options for cuboid syndrome?
Because cuboid syndrome can involve significant misalignment of the joint, correcting the damage will reverse the problem. Doctors may opt to realign the dislocation of the calcaneocuboid joint, through simple manipulation, although a visit to an osteopath may be required. Podiatrists, chiropractors and osteopaths tend to have a more complete working knowledge of both the condition and its treatment. In some cases, addressing the problem with tapes, pads, supports and orthotics can be all that is required. RICE (Rest, Ice, Compression and Elevation), non-steroidal anti-inflammatory drugs (NSAIDs) and cortisone injections can all help to reduce pain and any inflammation.
Cuboid syndrome is not a life-threatening problem, but the complications can be severe. The gradual degeneration of the joint can eventually lead to a loss of foot function, it is therefore important that the condition is properly diagnosed and treated.