Lateral Column Overload


Where is the Lateral Column of the foot?

The lateral column is comprised of the calcaneus, the cuboid and the fourth and fifth metatarsals as well as their respective joints, the calcaneocuboid, the cuboidometatarsal and the intermetatarsal joints.


What is Lateral Column Overload?

Lateral column pain has a variety of possible etiologies ranging from peroneal tendon disorders and cuboid syndrome to skewfoot and postoperative symptoms.

Lateral column pain is a descriptive term for a number of symptoms involving the joints and bones of the lateral column.

Lateral column pain may be due to arthritis, biomechanical abnormalities, acute fractures secondary to trauma or stress fractures secondary to chronic overuse. Other causes include tarsal coalition, peroneal tendonitis or subluxation, extensor digitorum brevis tendonitis, plantarflexion and inversion ankle injuries, cuboid subluxation and  following surgery.

Someone with lateral column pain will complain of acute or chronic pain in the area of the calcaneocuboid joint or the bases of the fourth and/or fifth metatarsal. The pain is usually greater with propulsion but may also be present during stance or non-weightbearing. Palpation should isolate the specific area of pain. Tenderness may also be present along the peroneal tendons or the origin of the extensor digitorum brevis muscle.

 


Causes of Lateral Column Pain

The literature is divided in reference to biomechanical etiologies of lateral column pain. Various authors have suggested that lateral column pain is associated with neutral, supinated and pronated foot types. Adducted foot types can cause an increase in mechanical pressures that can result in lateral column pain.2 Increased plantar pressures on the lateral column that one may see with neutral to supinated foot types can stress the cuboidometatarsal joints. Identifying the exact biomechanical etiology of lateral column pain is an important factor in providing appropriate treatment.

 


Diagnosis of Lateral Column Pain?

Typically diagnoses of lateral column pain is based on the physical exam as radiographs show little benefit in diagnosis.

However, stress and acute fractures and  tarsal coalition in the younger patient can indicate pathology. Due to the nonspecific nature of the pain and the lack of positive radiographic results, accurate diagnosis of lateral column pain can be a difficult process. While computed tomography (CT) and magnetic resonance imaging (MRI) can be useful tools in evaluating the lateral column, they are often unnecessary.

 


Treatment of Lateral Column Pain?

Treatment needs to address the cause of the lateral column overload, typically involving biomechanical realignment.

 


 

The Foot and Ankle Centre’s Northcote Podiatrists can help you with all lower limb complaints, including Bunionette. Make an appointment to get your foot and ankle pain under control.

Expert Podiatrists for the treatment of lateral foot pain servicing the areas of Northcote, Thornbury, Fitzroy, North Fitzroy, Carlton, North Carlton, Alphington, Fairfield, Brunswick, Coburg and Preston