The cuboid is one of the smaller bones of the foot. It’s attached to the heel by a series of ligaments. This little bone, which resembles a cube (thus, the name), can cause big problems if you develop a condition known as cuboid syndrome.

Here’s some information on cuboid syndrome, including causes and symptoms, as well as ways to improve the condition.

What Causes Cuboid Syndrome?

Cuboid syndrome occurs when the cuboid is partially dislocated. The usual cause is some sort of sudden injury such as a sprained ankle, but it can also occur due to repetitive wear and tear on the foot.1 Some of the more common causes of cuboid syndrome include:

cuboid diagram· Flat feet – Many of the patients who eventually suffer from cuboid syndrome have flat feet.
· Repeated stress – Most people put a great deal of stress on their feet every day. This could be due to working on your feet, running regularly, or playing a sport, such as basketball. When the cuboid bone is subjected to a lot of pressure on a regular basis, it can gradually weaken and then dislocate.
· Ankle sprain – This is the most common type of injury that contributes to cuboid syndrome. It occurs when the cuboid is forced outward as the heel and foot are suddenly turned inward. A sprain damages the tissues that keep the cuboid in place, causing it to become dislocated.2

While it’s not clearly known exactly how dislocation of the cuboid takes place, researchers believe there are several different factors that can increase a person’s risk of experiencing this problem. These include excessive weight, shoes that don’t fit correctly, and instability in the middle portion of the foot.3

What are the Symptoms of Cuboid Syndrome?

The symptom most closely associated with cuboid syndrome is pain that courses through the outside portion of the foot. Discomfort is usually at its worst when you first get out of bed in the morning, or when you have to quickly change direction while walking or running. Pain can also increase when you walk on an uneven surface. You may also notice that the area of the dislocation is swollen, red, and painful to the touch. Some people also experience weakness as they try to push off of the affected foot when jumping or running.4

Diagnosing Cuboid Syndrome

Cuboid syndrome is challenging to diagnose. There are no tests specifically designed for the condition, and it usually doesn’t show up on MRIs, x-rays, or CT scans.5 There are, however, two tests that can give a doctor a good idea of whether or not a patient has it.

One test is known as a midtarsal supination test. This involves stabilizing the ankle while manipulating the foot by rotating it in a semi-circle. If the patient experiences pain near the heel, that’s usually a good indication they have cuboid syndrome.6 The other test is known as a midtarsal adduction test. The ankle is once again stabilized, but in this test, the foot is moved inward. By performing this movement, the doctor compresses the joint near the cuboid to see if the patient experiences any pain in the area.7

Cuboid Syndrome: Finding Relief

physical therapy cuboid syndrome

Physical therapy is the most commonly recommended method to help people find relief from cuboid syndrome. A doctor may choose to wait a bit if the patient has suffered an ankle sprain, allowing the joint to heal before beginning physical therapy.8

Ultrasound, electrical stimulation, ice, or massage may also help manage any discomfort. Medical tape and padding may help support the cuboid and keep another dislocation from occurring. Stretching and other exercises can also help alleviate symptoms and prevent a recurrence of the problem. People who develop cuboid syndrome may also benefit from using orthotic devices inside their shoes. In some cases, orthotics may be custom-made.9

Prevention

Unfortunately, there aren’t a lot of things you can do to help prevent cuboid syndrome. What you can do is maintain a healthy weight, and make sure your shoes fit properly. Doing both of these things can help take stress off of your foot and help reduce the chances that a dislocation will occur. In addition, if you are a runner, try to stay on even surfaces.

The Takeaway

Don’t ignore discomfort in your feet. If you’re feeling pain in the area where the cuboid bone is located, see a doctor. Addressing the problem quickly can help you find relief, and stave off future complications down the road!

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References
1. https://www.healthline.com/health/cuboid-syndrome
2. https://www.physioadvisor.com.au/injuries/foot/cuboid-syndrome/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445231/
4. https://www.epainassist.com/sports-injuries/foot-and-heel-injuries/cuboid-syndrome-or-cuboid-subluxation
5. http://www.foot-pain-explored.com/cuboid-syndrome.html
6. http://0344936.netsolstores.com/pdfs/Update_1997/1997_27.pdf
7. http://www.jospt.org/doi/pdf/10.2519/jospt.2005.35.7.409?code=jospt-site
8. http://www.footvitals.com/injuries/cuboid-syndrome.html
9. https://www.podiatrytoday.com/article/3036

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About the Author

Dr. David Watts

Dr. David Watts is a world-famous plastic surgeon working at Johns Hopkins Medical School. He also spent 16 years in the Army Reserve, reaching the rank of Major, and is blessed to have helped thousands of our nation’s soldiers at Walter Reed Army Medical Center.