Sports Medicine: Cuboid Syndrome - The Foot Pain That Won’t Go Away

running injury male Alameda podiatrist NiccoliA few days ago, I saw a 25-year-old male with lateral foot pain who had gone through multiple doctors and six months’ worth of tests and treatments—including x-rays, ultrasound to check blood flow, pain medication, and physical therapy—without results. He had significant swelling along the ankle and the side of the foot, and was in fact getting worse instead of better.

Diagnosing cuboid syndrome: A tricky business

The patient was referred to me with a diagnosis of “unclear.” When he arrived for his initial appointment, he indicated his pain level as severe—an 8 on a scale of 1 to 10. Based on his symptoms profile and the clinical exam we performed, I suspected that he might have cuboid syndrome. This relatively rare diagnosis is almost never pronounced outside a podiatrist’s office, which has led to controversy over whether or not it actually exists.

Just to be sure, we took x-rays to rule out the possibility of more common problems like stress fractures, bone cysts, or tumors. In some cases, a subtle dislocation of the cuboid can be seen on x-rays and assist with the diagnosis. While no dislocation appeared with this patient, the absence of this anomaly does not rule out the possibility of the condition. It’s generally a clinical judgment call.

Cuboid syndrome treatment: Relief at last

Once we had eliminated other possibilities, we performed what is called a cuboid manipulation. This is an osteopathic type maneuver designed to shift the position of a single bone in the foot—in this case, the cuboid. During the process, patients sometimes feel what’s described as a “pop” or a “click” as the bone moves back into place. The patient reported feeling this sensation.

To support the manipulation, we applied a custom-made cuboid pad, with a Kinesiotape low-dye splint to keep it in place, and scheduled a follow-up appointment for one week. Upon his return, the patient stated that the results were “amazing”—he had experienced approximately 70% relief from the months-long pain.

Long-term follow-up care

This patient was unfortunately relocating to Virginia. However, I recommended that he have the cuboid manipulation treatment repeated 4 to 5 times, with appropriate padding and support. Ultimately, he should progress to a high-quality over-the-counter insole or functional orthotic, with an appropriately placed, customized cuboid pad to maintain the proper position of the bone long-term.

If you’re experiencing prolonged or chronic foot pain that can’t be explained, Dr. Niccoli offers advanced diagnostics and state-of-the-art tools to pinpoint the issue and deliver relief.

Click here or Call us now at 510-521-3410  ~ Dr. Jeffrey J Niccoli  Board-Certified, Alameda Family Podiatry Group. Serving  Bay Area patients from San Francisco, Oakland, Fremont, and Alameda

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