Baxter’s nerve entrapment is a cause of heel pain whereby entrapment of a nerve, commonly known as “Baxter’s nerve,” occurs. This nerve runs from the inside of the heel, under the arch of the foot to the outer heel. Baxter’s nerve entrapment is hard for medical professionals who do not specialize in the foot to diagnose. It causes symptoms similar to plantar fasciitis and usually also co-exists with it. It is an often overlooked cause of heel pain and literature estimates it to be the cause of 1 in 5 cases of medial heel pain.
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Symptoms
The following signs or symptoms may be indicative of a Baxter’s nerve entrapment: • Chronic pain on the inside (medial aspect) of the heel. • A radiating or burning pain under the heel. • Where pain has persisted for some time, there can be numbness/pain in the outside (lateral) part of the heel or foot. • Symptoms are usually worse following activity.
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Causes
This condition is caused by either compression or entrapment of 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 • Fat pad atrophy (heel) • An 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.
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Treatment
RICE (rest, ice, compression, elevation) and anti-inflammatory medications can help reduce the inflammation present, which in turn, will reduce pain. However, best treatment practices include assessing for biomechanical concerns and considering orthotics or footwear to best address the entrapment and open up the narrow space. Although surgery is an option, it should be considered a last resort as conservative therapies are generally successful.
