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Next Step Foot & Ankle Clinic

Cuboid Syndrome

Cuboid Syndrome is an unusual condition.  It is not exactly clear what happens to the Cuboid to cause this condition.  It appears that the cuboid bone (which is much shaped like a cube) becomes mis-aligned or the ligaments around the bone become strained or torn.  This can result from an ankle sprain, repetitive walking or running, or no precipitating cause.  I see it very often in patients who have a short Achilles tendon.  This places an unusual stress on the midfoot and the ligaments are strained and sometimes the bone slips.  Unfortunately, this cannot be seen on x-ray in most patients.  It is usually a diagnosis that is made by careful physical examination and symptoms.  

What Cuboid Syndrome feels like:  The pain from cuboid syndrome can range from minor discomfort to quite severe and disabling.  Very frequently the patient describes the sensation that the foot needs to "pop".  The location of the pain is on the top of the foot and sometimes on the bottom over the outside of the foot just in front of the ankle.  

Risk Factors for Developing Cuboid Syndrome:

     1.  Tight Achilles tendon (I see this condition in almost every patient that I diagnose with cuboid syndrome.)

     2.  Non-supportive shoes.

     3.  Increased body mass index (being overweight).

     4.  Working or walking on uneven surfaces.  


As with any injury:  rest, ice, and elevation--if swollen.  Sometimes a manipulation is needed to move the cuboid back into its location.  Steroid injections in the adjacent joints can be a great help with decreasing the symptoms.  They can also help with anesthetizing the joint so it can be successfully manipulated.  Taping the foot is also very helpful in controlling the symptoms and moving the bone back into alignment.  Arch supports are also critical in treating this condition.  Sometimes, custom orthotics are needed.  Stretching the Achilles and use of a night splint can be helpful as well.  Rarely is surgery required.