What is cuboid syndrome?
Symptoms: Pain on the lateral (outside) part of the foot. There is often no associated accident or injury to this area, though sometimes twisting one's ankle can exacerbate it. Often it develops slowly and for no apparent reason. It will usually feel worse when standing on the affected foot. Walking is also usually painful. Wearing shoes that are tight around the forefoot can become unpleasant.
Cause: It is theorized that the syndrome occurs when the foot pronates excessively, causing a misalignment of the cuboid bone. Personal experience suggests that this is partly true. My most observation is that most commonly the affected side is the foot that is too far midline. People rarely stand perfectly symmetrical. Usually one foot is more medial. Or to say it another way, is that the foot is more underneath you. This usually results in excessive pronation, as well as more forces being absorbed by the affected foot in standing, walking and running. Athletic activity increases one's chances of getting cuboid syndrome.
Diagnosis: Examination may reveal some swelling. Cuboid pain and tenderness to palpation is typical. X-rays will often show nothing, as alignment is not always discernable. Absence of fracture is a good indication. Whereas misalignment is the primary pain mechanism, radiological imaging is not often necessary for diagnosis. Considering the cost of soft tissue imaging techniques like MRI and CT scans, it makes more sense to attempt therapy before even considering these expensive options.
Treatment: manual manipulation is extremely effective when performed by a skilled professional. Multiple treatments is usually necessary. Total number of treatments is dependent upon how long the patient has had cuboid syndrome.
Dr. Schafer's note: As I previously stated, cuboid syndrome is usually due to asymmetrical stance and gait. When one foot is more medial (midline), not only is the foot misaligned, but so is the knee, hip, pelvis and spine. Long term success depends on re-alignment of the whole system. Chiropractic manual adjustments techniques are extremely helpful, as well as core exercises. Yes-core exercises are better than foot exercises for long term success.
