Today, we're gonna talk about a less common problem called pain on the outside of your foot. So much of the time, people come in and it's the arch pain and heel pain, but people do have symptoms on the other side of the foot.

What Causes Pain on the Outside of the Foot?

So, where do these painful problems come from? When I examine the foot, the first thing I think of, is of course, localizing where the pain is. People think if the pain is over on the side, in the back, it's the ankle. Oftentimes when you're actually evaluated, it's slightly below the ankle.

And then we have to distinguish between problems in soft tissue, like tendons, and problems in bone, like the joints. So, what are some of the most common points in pain on the outside of the foot?

What is Cuboid Syndrome?

One of the most common problems on this side of the foot, is pain under a cube shaped bone, just in front of the ankle. And underneath there's a trough in this bone because you have a major tendon coming from the outside of the ankle, under here, all the way over to the other side of the arch. And it is very important. It prevents us from spraining our ankle. When we walk it fires to pull us back over the big toe joint. This tendon is called the peroneous longus tendon and the syndrome that occurs when it becomes inflamed is called cuboid syndrome.

Inflammation of the Peroneaus Brevis Tendon

Another tendon called, peroneaus brevis, attaches to the base of your fifth metatarsal bone. You can feel this bony prominence sticking out at the side of your foot. This tendon inserts right at the point of that bone. And I've seen a few cases even in the last couple of weeks, where this overpulls on the base of this bone and creates pain and inflammation here. Notice, not much distance between there and the bottom of the other bone, where we had the cuboid syndrome. But they can be distinguished simply by palpating the foot and feeling the location point of pain.

Joint Pain

Another reason for pain on the outside of the foot is joint pain.  This pain can occur from the rear part of the foot, under the ankle, to next joint up where the heel bone joins the cuboid bone, and then finally, right across the midfoot. Each of these problems is a little different in cause but if we distinguish which ones they are, we will also sometimes use a local injection of an anesthetic, sometimes with cortisone, to further isolate which joint is bothering you.

X-rays can also be helpful in deciding whether or not there's any degeneration or arthritis in that area. But if those aren't present, we usually are led back to figuring out what mechanically is going wrong with the foot, and then designing supports for you to help minimize this and eliminate pain on the outside of your foot.

If you're having problems with pain on the outside of the foot, come on in and let's figure this out together, get you back to your activities quickly.

Dr. Rion Berg
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A podiatrist in North Seattle treating families for over 40 years.