Pain on the Outer Side of the Foot – Cuboid Syndrome

Cuboid syndrome is a painful condition that develops as a result of damage to the joints and ligaments around the cuboid bone in the foot. It causes pain on the outer side of the foot, on the little finger side. Pain can be felt in the middle of the foot, at the root of the fourth and fifth toes.

Cuboid bone heel bone with calcaneus 4-5. It is located between the metatarsal bones. It is adjacent to the lateral cuneiform and navicular bones on the inside.

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Why Does It Happen?

There is partial dislocation (subluxation) of the cuboid bone on the outer edge of the middle part of the foot. The bone is displaced downwards out of normal alignment with the adjacent calcaneus bone. A sudden trauma or overuse injury can cause this. Overuse injury is caused by prolonged intense activity. It is more common in athletes and dancers. Tennis with fast side moves is risky in this respect.

Sports done with unsuitable shoes, on uneven ground and without paying attention to rest periods increase the risk. Being overweight is also a risk factor.

Sprains in which the ankle turns inward can lead to cuboid syndrome. Rarely, it can occur in an outward sprain. Cuboid syndrome has been reported more frequently in those who walk with their feet inward. Tension of the calf muscles (peroneus longus) can cause the cuboid to retract with the foot turned inward.


  • Pain on the outer side of the foot
  • Pain can develop suddenly or over time.
  • Blunt, aching or sharp, acute pain
  • pain while walking
  • Jumping can be very painful
  • Edema can be seen
  • Pain may increase when raised on the tip of the toe
  • Movement of the foot and ankle may be restricted
  • Tenderness on the sole of the foot
Read More  Calcification in Foot Joints

What Situations Can It Confuse With?

  • Stress fracture (in cuboid, calcaneus or 4th-5th metatarsal bones)
  • ankle sprain
  • Kalkaneonavicular coalition
  • Plantar fasciitis
  • Sinus tarsi syndrome
  • Tendon (longus peroneus, ekstansör digitorum brevis)
  • Neuropathy (sural nerve, lateral plantar nerve)
  • Gut
  • Anterolateral ankle impingement

How is the diagnosis made?

The foot is one of the most complex parts of our body. It contains 28 bones, 30 joints, around 100 muscles, ligaments and tendons. It can be difficult to diagnose because the symptoms of cuboid syndrome are not very specific. Techniques such as X-ray, MRI may result in normal results, but are useful to rule out other possible problems. Diagnosis is made by medical history and physical examination. Midtarsal adduction test and midtarsal supination test are specific maneuvers to diagnose cuboid syndrome in physical examination.


Rest is the first step. It is necessary to avoid activities that force the foot. Cold application, gentle compression with an elastic bandage (compression) and keeping the foot elevated are treatments that can be done by the person himself.

In cuboid syndrome, treatment may be possible by normalizing the alignment of the bone with special manipulation (cuboid whip and cuboid tightening techniques). For this, you can be examined by a physical therapy and rehabilitation doctor. Manipulation may be objectionable in other problems that may cause similar complaints such as fractures, circulatory problems, arthritis.

The use of insoles, kinesiotape or other taping methods, massage, exercise (stretching, strengthening, balance), pain relievers are other treatment options.

Healing may take several days or weeks, depending on the severity and cause of the problem. Most cases recover fully. The risk of recurrence is low.

Read More  Tethered Cord Syndrome

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