What is a subluxed cuboid or cuboid syndrome?
A subluxed cuboid or cuboid syndrome is a condition characterised by partial dislocation of the cuboid bone in the foot.
The cuboid is part of the lateral column located on the outer aspect of the mid-foot. It is connected to adjacent bones via strong connective tissue forming joints. These joints provide outer foot stability and allow movement to take place. As the definition suggests the cuboid slips out or subluxes from its resting spot behind the fourth and fifth metatarsals.
During weight bearing activity, certain movements of the foot and ankle and contraction of certain muscles of the lower leg and foot (e.g. peroneus longus), stress is placed on the cuboid bone and surrounding soft tissue. If these forces are excessive and beyond what the bone and surrounding soft tissue can withstand, tearing of the supportive connective tissue may occur. This may allow the cuboid bone to sublux or partially move out of its normal alignment relative to the adjacent foot bones. When this occurs, the condition is known as cuboid syndrome.
The causes of cuboid syndrome
Cuboid syndrome does not always involve ligament damage. The main culprit is certain movements and forces that occur particularly in dancers and athletes. Most often there will be no major trauma, like a fall, but more often a quick pivoting type movement as the initial triggering event. This causes damage to the tissues holding the cuboid bone in position. As example would be a tennis player quickly running and then the foot suddenly turning internally at the net with a sudden quick stopping motion.
Even though a quick movement shift is typically to blame, evaluation for any biomechanical issues in the lower limbs is vitally important. Most patients who develop this condition have excessively pronated feet (flat feet) although the condition may also be seen in those with lateral ankle instability. The correction of any biomechanical issues should be part of the overall treatment plan. These may include limb length discrepancy, abnormal pronation or supination issues.
Signs and symptoms of cuboid syndrome
Patients with cuboid syndrome will usually experience outer (lateral) foot pain that increases with weight bearing forces through the outer foot and may cause weakness during the push off phase of gait. Pain will often increase with twisting or with running (particularly on hard surfaces and in unsupportive shoes). Pain may radiate into the bottom of the foot, the front of the ankle or into the toes. In more severe cases, the patient may limp or walk on their toes in an attempt to reduce stress on the cuboid bone. Pain may also increase on firm palpation of the cuboid bone.
Diagnosis of cuboid syndrome
An examination from a podiatrist is imperative to help with diagnosis of cuboid syndrome. Investigations such as an X-ray, ultrasound, MRI and CT scan may be required to confirm the finding and rule out other injuries. Often x-rays are usually negative, as the slight rotation of cuboid is tough to see, though there may be a small gap at the calcaneocuboid joint.
Treatment for cuboid syndrome
At Entire Podiatry most patients with cuboid syndrome heal with appropriate conservative treatment without the need of surgery. It is important to treat any underlying biomechanical issues. If cuboid syndrome occurs due to repeated ankle sprains, then strengthening, footwear advice and controlling abnormal biomechanics with orthotics is required. Treatment usually also includes manipulation of the cuboid bone to reverse the subluxation and temporary padding and taping to maintain the position of the cuboid.
Our goal is to relieve 100% of your Morton’s neuroma pain without surgery. We are extremely successful at providing relief in a conservative manner and we have a wide variety of treatments that we use to help cure your pain.
