Cuboid Syndrome

The cuboid is a small cube shaped bone on the outside of the foot around about the center of the foot. The bone is a little larger than a common gaming dice. The bone takes part in 3 joints and operates as a pulley for the tendon of the peroneus longus tendon to pass under. As this is a powerful muscle it may move the cuboid bone too much if it is not stable and strain those joints that this bone is a part of producing a condition known as cuboid syndrome. This is probably one of the more common reasons for pain on the outside of the foot, particularly in athletes. The pain commonly begins quite moderate and is located around where the cuboid bone is on the outside of the foot. The pain is only initially present during exercise. If the activity amounts are not lowered the condition will most likely progress and then show up after activity in addition to during. Occasionally the pain can radiate down into the foot. Although this is the commonest cause of pain on the lateral side of the foot, there are others such as tendon problems and nerve entrapments.

The main management of cuboid syndrome is relief of pain. This is generally achieved with a decrease in activity levels and the using of strapping to immobilise and support the cuboid. Mobilisation and also manipulation is generally used to treat cuboid syndrome. Over the long run foot supports may be required to limit the movement and aid the lateral arch of the foot. This helps make the cuboid more stable so it is an efficient fulcrum or pulley for the tendon to function under. Commonly this strategy works in most cases. If it doesn’t there are no operative or more advanced methods and a further decrease in exercise levels is generally the only alternative.

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