Two examples of ‘cuboid syndrome’ with active bone pathology: Why did manual therapy help?

Mark Matthews, A.P. Claus

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Cuboid syndrome describes lateral midfoot pain localised to the cuboid bone. Previously reported case studies promoted joint mobilisation or manipulation interventions. The assumed mechanism was correction of a subtle disruption to the calcaneocuboid joint position. There is an absence of evidence for
correction of joint position, but there is evidence of neurophysiological mechanisms for pain modulation.
This case study reports on a patient who suffered two occurrences of cuboid syndrome on opposite feet, three years apart. With both occurrences, joint mobilisation achieved rapid and lasting resolution of severe pain and functional limitations. This occurred despite the presence of an active bone pathology at
the symptomatic cuboid (demonstrated with nuclear imaging), which could represent a stress reaction,
transient osteoporosis, ischaemic necrosis, infection or neoplasm. This case contributes three considerations for clinical reasoning and manual therapy research. 1. Active local bone pathology could exist in other patients with pain at the cuboid, and other conditions where symptoms resolve with joint
mobilisation. 2. Rapid and lasting symptom resolution fits with a hypothesis that joint mobilisation acted to reverse neurological sensitisation. 3. Lasting symptom resolution may be clinically associated with manual therapy, but mechanisms extending beyond temporary analgesia are yet to be identified.
LanguageEnglish
Article number19
Pages494-498
Number of pages5
JournalManual Therapy
DOIs
Publication statusPublished - Oct 2014

Fingerprint

Musculoskeletal Manipulations
Joints
Pathology
Bone and Bones
Pain
Tarsal Bones
Analgesia
Osteoporosis
Foot
Necrosis
Infection
Research
Neoplasms

Keywords

  • Manual therapy
  • Mobilisation
  • Cuboid
  • Neurophysiology

Cite this

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title = "Two examples of ‘cuboid syndrome’ with active bone pathology: Why did manual therapy help?",
abstract = "Cuboid syndrome describes lateral midfoot pain localised to the cuboid bone. Previously reported case studies promoted joint mobilisation or manipulation interventions. The assumed mechanism was correction of a subtle disruption to the calcaneocuboid joint position. There is an absence of evidence forcorrection of joint position, but there is evidence of neurophysiological mechanisms for pain modulation.This case study reports on a patient who suffered two occurrences of cuboid syndrome on opposite feet, three years apart. With both occurrences, joint mobilisation achieved rapid and lasting resolution of severe pain and functional limitations. This occurred despite the presence of an active bone pathology atthe symptomatic cuboid (demonstrated with nuclear imaging), which could represent a stress reaction,transient osteoporosis, ischaemic necrosis, infection or neoplasm. This case contributes three considerations for clinical reasoning and manual therapy research. 1. Active local bone pathology could exist in other patients with pain at the cuboid, and other conditions where symptoms resolve with jointmobilisation. 2. Rapid and lasting symptom resolution fits with a hypothesis that joint mobilisation acted to reverse neurological sensitisation. 3. Lasting symptom resolution may be clinically associated with manual therapy, but mechanisms extending beyond temporary analgesia are yet to be identified.",
keywords = "Manual therapy, Mobilisation, Cuboid, Neurophysiology",
author = "Mark Matthews and A.P. Claus",
note = "Adams E, Madden C. Cuboid subluxation: a case study and review of the literature.Curr Sports Med Rep 2009;8:300e7. Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther 2009;14:531e8. Blakeslee TJ, Morris JL. Cuboid syndrome and the significance of midtarsal joint stability. J Am Podiatr Med Assoc 1987;77:638e42. Brukner PD, Khan KM. Clinical sports medicine. 3rd ed. McGraw-Hill Australia Pty Ltd; 2007. p. 659. Chowdhury FU, Robinson P, Grainger AJ. Transient regional osteoporosis: a rare cause of foot and ankle pain. Foot Ankle Surg 2006;12(2):79e83. Coppieters MW, Stappaerts KH, Wouters LL, Janssens K. Aberrant protective force generation during neural provocation testing and the effect of treatment in patients with neurogenic cervicobrachial pain. J Manipulative Physiol Ther 2003;26:99e106. Durall CJ. Examination and treatment of cuboid syndrome: a literature review. Sports Health 2011;3:514e9. Fernandez-Canton G, Casado O, Capelastegui A, Astigarraga E, Larena JA, Merino A. Bone marrow edema syndrome of the foot: one year follow-up with MR imaging. Skeletal Radiol 2003;32:273e8. Gigena M, Chung Christine B, Lektrakul Nittaya. Transient bone marrow edema of the talus: MR imaging findings in five patients. Skeletal Radiol 2002;31:202e7. Hegedus EJ, Goode A, Butler RJ, Slaven E. The neurophysiological effects of a single session of spinal joint mobilization: does the effect last? J Man Manip Ther 2011;19:143e51. Hensley CP, Kavchak AJE. Novel use of a manual therapy technique and management of a patient with peroneal tendinopathy: a case report. Man Ther 2012;17: 84e8. Hsieh CY, Vicenzino B, Yang CH, Hu MH, Yang C. Mulligan’s mobilization with movement for the thumb: a single case report using magnetic resonance imaging to evaluate the positional fault hypothesis. Man Ther 2002;7:44e9. Jennings J, Davies GJ. Treatment of cuboid syndrome secondary to lateral ankle sprains: a case series. J Orthop Sports Phys Ther 2005;35(7):409e15. Limaye R, Tripathy SK, Pathare S, Saeed K. Idiopathic transient osteoporosis of the talus: a cause for unexplained foot and ankle pain. J Foot Ankle Surg 2012;51: 632e5. Marshall P, Hamilton WG. Cuboid subluxation in ballet dancers. Am J Sports Med 1992;20:169e75. McConnell J. Management of a difficult knee problem. Man Ther 2013;18:258e63. Mooney M, Maffey-Ward L. Cuboid plantar and dorsal subluxations: assessment and treatment. J Orthop Sports Phys Ther 1994;20:220e6. Newell SG, Woodle A. Cuboid syndrome. Phys Sports Med 1981;9:71e6. Patterson SM. Cuboid syndrome: a review of the literature. J Sports Sci Med 2006;5(4):597e606. Paungmali A, Vicenzino B, Smith M. Hypoalgesia induced by elbow manipulation in lateral epicondylalgia does not exhibit tolerance. J Pain 2003;4:448e54. Schmid A, Brunner F, Wright A, Bachmann LM. Paradigm shift in manual therapy? Evidence for a central nervous system component in the response to passive cervical joint mobilisation. Man Ther 2008;13:387e96. Sterling M, Jull G, Wright A. Cervical mobilisation: concurrent effects on pain, sympathetic nervous system activity and motor activity. Man Ther 2001;6: 72e81. Subotnick SI. Peroneal cuboid syndrome. J Am Podiatr Med Assoc 1989;79:413e4. Vicenzino B, Collins D, Benson H, Wright A. An investigation of the interrelationship between manipulative therapy-induced hypoalgesia and sympathoexcitation. J Manipulative Physiol Ther 1998;21:448e53. Vicenzino B, Collins D, Wright A. The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia. Pain 1996;68:69e74.",
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Two examples of ‘cuboid syndrome’ with active bone pathology: Why did manual therapy help? / Matthews, Mark; Claus, A.P.

In: Manual Therapy, 10.2014, p. 494-498.

Research output: Contribution to journalArticle

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AU - Matthews, Mark

AU - Claus, A.P.

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AB - Cuboid syndrome describes lateral midfoot pain localised to the cuboid bone. Previously reported case studies promoted joint mobilisation or manipulation interventions. The assumed mechanism was correction of a subtle disruption to the calcaneocuboid joint position. There is an absence of evidence forcorrection of joint position, but there is evidence of neurophysiological mechanisms for pain modulation.This case study reports on a patient who suffered two occurrences of cuboid syndrome on opposite feet, three years apart. With both occurrences, joint mobilisation achieved rapid and lasting resolution of severe pain and functional limitations. This occurred despite the presence of an active bone pathology atthe symptomatic cuboid (demonstrated with nuclear imaging), which could represent a stress reaction,transient osteoporosis, ischaemic necrosis, infection or neoplasm. This case contributes three considerations for clinical reasoning and manual therapy research. 1. Active local bone pathology could exist in other patients with pain at the cuboid, and other conditions where symptoms resolve with jointmobilisation. 2. Rapid and lasting symptom resolution fits with a hypothesis that joint mobilisation acted to reverse neurological sensitisation. 3. Lasting symptom resolution may be clinically associated with manual therapy, but mechanisms extending beyond temporary analgesia are yet to be identified.

KW - Manual therapy

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JF - Manual Therapy

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