What is Baxter’s nerve entrapment?

Baxter’s nerve entrapment is a heel pain condition caused by entrapment of the 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 similar to plantar fasciitis and often co-exists with it. It is an often overlooked cause of heel pain and literature estimates it to be the the cause of 20% of medial heel pain cases.

Do you suffer from Baxter’s nerve entrapment?

Signs & symptoms of Baxter’s nerve entrapment

The following signs or symptoms may indicate Baxter’s nerve entrapment in the foot:

  • Chronic pain on the inside (medial aspect) of the heel.
  • A radiating or burning pain under the heel.
  • In long standing cases there can be numbness in the outside (lateral) part of the heel or foot.
  • Symptoms are often worse following activity.

Causes of Baxter’s nerve entrapment

Baxter’s nerve entrapment is caused by either compression, impingement or entrapment of the inferior calcaneal nerve (Baxter’s nerve). Common causes of Baxter’s nerve entrapment include:

  • Poor foot mechanics or excess foot pronation (rolling inwards of the foot).
  • Flat feet
  • Compression from poor footwear or poorly prescribed orthotics.
  • Heel pad atrophy
  • An acute injury to the foot that results in swelling around the inside or underneath the heel.
  • Repetitive overuse or trauma to the nerve during certain activities e.g. running.

Baxter’s nerve diagnosis

Baxter’s nerve entrapment is often hard to diagnose as it often mimics and coexists with other heel pain causing conditions such as plantar fasciitis. However our podiatrists are experts in plantar heel pain and can usually diagnose Baxter’s nerve entrapment clinically without the need for further scans. In cases of doubt or where the cause is not established then our podiatrists may refer you for an MRI scan to aid diagnosis.

Our clinic also has its own on site diagnostic ultrasound machine which can aid diagnosis of other coexisting heel pain conditions such as plantar fasciitis. This results in better overall treatment of your plantar heel pain.

Podiatry treatment for Baxter’s nerve entrapment

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

Common podiatry treatment options include:

  • Foot strapping
  • Orthotics to address foot mechanics
  • Stretching and strengthening programs
  • Footwear advice and modification
  • Rest, ice and activity modification
  • Oral medications (such as NSAIDs)
  • Ultrasound therapy and heat

NB. Poorly prescribed orthotics is an often overlooked cause of nerve compression and can result in Baxter’s nerve entrapment.

Custom orthotics are often a great help to treat Baxter’s nerve entrapment when there is an underlying biomechanical cause. However they must be prescribed accurately by experienced podiatrists. A poor orthotic prescription may actually do the opposite and increase nerve compression, exacerbating heel pain symptoms. Our podiatrists have seen many cases of Baxter’s nerve entrapment caused by poorly prescribed orthotics and by practitioners who haven’t diagnosed Baxter’s nerve entrapment as a cause of heel pain.

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 or CAM walker
  • Injection or cortisone therapy
  • Surgery
Call us Melbourne Podiatrist

Do you need treatment for Baxter’s nerve entrapment?

At our Melbourne foot clinic our podiatrists are experts in the diagnosis and treatment of heel pain conditions affecting the foot, including Baxter’s nerve entrapment.

So if you are suffering from a burning or radiating pain in your heel or you think you may have Baxter’s nerve entrapement book an appointment with one of our friendly podiatrists today!