The Oustide of My Foot Really Hurts!

What is the lateral column of my foot? The lateral column of the foot consists of the calcaneus,the cuboid and 4th and 5th metatarsal bones. Many things can cause you to have lateral column pain including arthritis, biomechanical abnormalities (the way you walk), acute fractures secondary to trauma, or overuse syndrome.

There are certain types of foot structures that make you more likely to develop lateral column foot pain. An adducted foot type can cause an increase in mechanical pressures that can result in lateral column pain. Increased plantar pressures on the lateral column may also be seen in a neutral or supinated foot type. Pronation or flat feet can also lead to lateral column pain.

The most common cause of lateral column pain is known as cuboid syndrome or subluxation of the cuboid bone. This is often difficult to diagnose as the symptoms are not specific. X-rays will be negative because there is not any bone damage with this disease. Often the diagnosis is based on your history and physical and evaluation of your gait cycle. Most often the pain is greater with propulsion and disappears when sitting or pushing on the foot.

Joint stability plays a large role in the development of cuboid syndrome. If your foot is able to pronate during the beginning phase of propulsion it allows certain tendons (peroneus longus) to gain a greater mechanical advantage leading to the subluxation of the cuboid bone. This allows the ligaments and capsule that surround the joints to become irritated and inflamed and cause pain.

How do you treat Lateral Column Pain?

An evaluation of your gait will be one the first treatments. At this time proper shoe gear will be discussed. Accomodative padding,taping, bracing and physical therapy can help with reducing inflammation and pain. Many times the foot needs to be manipulated to allow the bone to sit back into its normal position. Custom orthotics may be necessary to address the biomechanics of your feet.