Baxter’s Nerve Entrapment – one of our key Differential Diagnosis for Plantar Fasciitis/heel pain.

Do you have heel pain not responding to traditional management. Do you have burning around the heel?

Baxter’s nerve entrapment is a heel pain condition caused by entrapment of the inferior calcaneal nerve, also commonly known as “Baxter’s nerve”. This nerve originates from the lateral plantar nerve, close to the bifurcation of the tibial nerve. It runs from the inside of the heel, under the arch of the foot to the outer heel.

Baxter’s nerve entrapment is often hard to diagnose as it causes symptoms like plantar fasciitis and often co-exists with it.

Symptoms include burning pain or pins and needles under and around the heel. Pain is often worse the longer you have been on your feet rather than pain on the first few steps in the morning.

Diagnosis is by ultrasound or MRI and there is often associated reduction in muscle mass of the abductor digiti minimi muscle on the outer sider of the foot.

Treatment for Baxter’s nerve entrapment is aimed at treating the cause and reducing the compression or damage to the Baxter’s nerve.

• Foot strapping
• Assessment of foot mechanics
• Stretching and strengthening programs
• Footwear advise
• Rest, ice and activity modification

Custom orthotics are often a great help to treat Baxter’s nerve entrapment when there is an underlying biomechanical cause. A poor orthotic prescription may do the opposite and increase nerve compression, exacerbating heel pain symptoms.

In more severe cases of Baxter’s nerve entrapment or in cases that don’t respond to conservative treatment the following treatment may be required:

• Immobolisation
• Injection or cortisone therapy
• Surgery