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pain on outside of foot that goes away when popped

by Bre
(Kansas)

Hello,

I have been having this issue for many years now. I get this pain on the outside edge of my foot, close to the middle. There is like a knobby spot, which is normal, but that is where the pain is. I have it every morning when i get out of bed and sometimes at random times during the day/evening when walking around. I know the only way to get the pain to go away is to "pop" that part of my foot by pushing down and out to the side. Sometimes it is really painful and hard to pop. One podiatrist said it could be this rare condition, but wouldn't tell me what it it's called. I'm very frustrated and hope you can give me some insight.
Thank you for any information you can give me.

RESPONSE

Hi Bre,

Although a couple of things come to mind, the condition that jumped out at me based on your narrative is what is known as a subluxed cuboid.

The knobby spot that you refer to more than likely would be the base of the fifth metatarsal bone, which appears as a protrusion to a varying degree in different individuals.

Adjacent to that bone, just behind it is the cuboid bone.

This is a roughly square bone that for some reason can slightly pop out of place periodically, and when it does, it will begin to hurt. Many times the bone can be pushed back into place which for the most part will relieve the pain.

Truthfully, I have never seen or heard of a case of a subluxed cuboid that happens so frequently and for so many years.

I do not know how old you are, but it would seem to me that at some point in time it will become harder and harder to actually push the bone back in place, in fact, you may reach the point where you will no longer be able to push it back into place.

Most cases of a subluxed cuboid occur when there is inversion of the foot, in other words, the foot bends inwards relative to the leg, which puts excessive pressure on the bottom of the cuboid and forces it to move upwards.

What I find interesting is that you say this occurs during your sleep, or maybe I am misunderstanding and it occurs as you step out of bed on to the floor, which makes a little more sense to me.

If the cuboid bone is unstable and you step out of bed barefoot in a certain manner, in theory, you could force the cuboid upward and out of the way.

So, the obvious question is what can you do about this?

The diagnosis is usually made on clinical grounds based on your history. An x-ray or MRI is generally not very helpful in making the diagnosis. A CAT scan is considered the best test for making the diagnosis, but quite frankly if you can demonstrate the movement of the bone in front of your doctor, no other tests will be necessary.

Usually, people who are prone to this condition can be put into an orthotic which has a cuboid pad built into it to prevent motion. The problem with you is that it happens very frequently and it occurs when you are barefoot. An orthotic is worn in shoes and you cannot sleep with one attached to your foot.

If this is happening very frequently, which it sounds like it is, then you might have to entertain a surgical approach, where the cuboid bone is fused to the adjacent bone, to keep it from popping out.

You should see another foot specialist in your area as it sounds like the first doctor you went to, did not offer you much information or help.

Marc Mitnick DPM
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