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