admin@thefeetpeople.com.au

(07) 3356 3579

BOOK NOW
BOOK NOW

Baxters Nerve Entrapment

Jump to section

What is Baxters nerve entrapment?
Causes
 Symptoms
 Diagnosis
 Differentiating from other conditions
 Treatment
 Recurrence after treatment
 Prevention
 FAQs

When the Baxter’s nerve at the bottom of the heel becomes compressed or entrapped, it produces heel pain as well as other uncomfortable symptoms.

What Is Baxter’s Nerve Entrapment?

Medically known as the inferior calcaneal nerve, you have a nerve called the Baxter’s nerve that runs down the inside of the ankle to the bottom of the heel bone. It is a sensory nerve, meaning that it’s responsible for providing sensation (feeling) to the heel and arch of the foot. The nerve is surrounded by an array of ligaments, tissues and other structures that make it susceptible to being compressed and trapped, particularly around an area called the medial tubercle at the bottom of the heel.

Baxter’s nerve entrapment is an important condition to know about because it’s commonly misdiagnosed as plantar fasciitis, the most common cause of heel pain, despite Baxter’s nerve entrapment being the true cause of the problem in approximately 20% of chronic heel pain cases. As nerve entrapments have different treatment considerations and pathways compared to plantar fasciitis, getting the right diagnosis and care is essential for long-term comfort and relief. This is where working with an experienced podiatrist who is familiar with Baxter’s nerve entrapment is invaluable.

Causes Of A Baxter's Nerve Entrapment

Baxter’s nerve entrapment occurs when the nerve is impinged, compressed or otherwise entrapped between two structures in the foot, such as between bone and connective tissue. Other causes and contributing factors include:

• Poorly fitting footwear, particularly shoes that do not provide proper arch support or have a tight toe box
  
• Poor foot biomechanics, such as excessive pronation (flat feet) or supination (high arches)
  
• Repetitive pressure and friction on the nerve during walking or standing, which can lead to irritation and compression
  
• Trauma or injury to the heel region, as the resulting inflammation can then compress the Baxter's nerve
  
• The development of conditions like plantar fasciitis or heel spurs may exacerbate the entrapment, while inflammatory conditions can also be a causative factor
  
• Fat pad atrophy beneath the heel can also play a role
  

Baxter's Nerve Entrapment Symptoms

The symptoms of a Baxter's nerve entrapment typically centre around the heel (inner and bottom areas) and include persistent pain that may be sharp or burning in nature, and tingling or numbness that can extend out from the heel and into the arch. Activities that involve prolonged standing, walking, or wearing shoes with inadequate support may exacerbate these symptoms, as can repetitive movements such as those that involve flexing or extending the foot.

Pressing on specific points along the inner heel may reproduce the pain (which helps our diagnostic process), and we may also notice changes in your gait (walking patterns) as you alter your walking style to try to reduce pain and discomfort.

Diagnosing Baxter's Nerve Entrapment

Our podiatrists diagnose Baxter’s nerve entrapment by completing a thorough clinical exam that involves understanding your medical history, risk factors and symptoms, palpating around the foot and arch to understand exactly where the symptoms are coming from, and going through a range of tests including range of motion testing, pressure testing, a gait analysis and more.

The key here is picking up on the subtle differences between Baxter’s nerve entrapment and plantar fasciitis, such as the lack of that first-step pain that plantar fasciitis is well known for. If there are any issues, the cause of your pain is unclear, or we suspect that you may be suffering from multiple injuries or conditions at once, then we will refer you for medical imaging to get a better look around your foot and heel.

Distinguishing Baxter's Nerve Entrapment from Other Conditions

Aside from plantar fasciitis that we mentioned above, other conditions that produce pain around the inside or bottom of the heel that need to be ruled out include heel bursitis, which involves the inflammation of a cushion-like ‘bursa’ at the heel, and heel pad syndrome, where the fat pad beneath the heel is injured or inflamed. Stress fractures can also cause heel pain, and tarsal tunnel syndrome is another nerve entrapment condition where the posterior tibial nerve is compressed, and may cause similar neurological symptoms.

Treating Baxter's Nerve Entrapment

Treating Baxter’s nerve entrapment focuses on reducing or alleviating the compression on the nerve, whether that’s from adjusting the foot biomechanics, reducing swelling in the area, or another approach. As such, effective treatment is very specific to the unique causes of a person’s entrapment and will vary. We may use:

• Custom foot orthotics: these effectively adjust your foot’s posture and biomechanics based on a custom prescription created by your podiatrist, which can effectively manage Baxter’s nerve entrapment that is caused by having a foot posture where the structures are positioned in a way that compresses or impinges upon the nerve. Orthotics will also help in many other ways, such as when the entrapment is caused by stress on a local structure that becomes swollen, contributing to the entrapment.
  
• Footwear assessment: we want to ensure your shoes are supporting your feet in a good, stable position, to best help manage your symptoms and reduce the risk of nerve entrapment
  
• Footwear modifications: in some cases, we may opt to make modifications to your existing footwear to best decompress the Baxter’s nerve and optimise your results
  
• Foot mobilisation therapy: FMT helps to free up the joints in your feet to move without restriction, therefore reducing the risk of mechanical impingements from the structures surrounding the Baxter’s nerve
  
• MLS laser: this is an effective form of pain relief that works on neuropathic pain, and may be beneficial if your symptoms are severe
  
• Stretching or strengthening exercises: to help address any muscle imbalances that may be contributing to your symptoms
  

In the few severe cases where pain relief is needed but traditional methods aren’t yielding the results that we’d expect, we may refer you for a corticosteroid injection to help manage your symptoms. Additionally, if we suspect that your symptoms are being produced by a mass like a cyst in the area, we may refer you for medical imaging to confirm your diagnosis, and may recommend involving a specialist like an orthopaedic surgeon in your care to help you get the best outcomes.

Can Baxter's Nerve Entrapment Return After Treatment?

This generally depends on the cause of your entrapment. If the cause is related to a specific injury in the area that is swollen and compresses the nerve as a result, then once the problem is treated, it generally won’t return unless you sustain the same injury again. If the cause is solely from your current foot biomechanics, then if you remove the supportive measures such as your orthotics, or you stop wearing good shoes that help distribute weight well across the foot, then you may find your symptoms returning. Thankfully, in most cases this is usually remedied by restarting using the devices that keep your feet well-supported and moving efficiently. 

How To Prevent Baxter’s Nerve Entrapment

As Baxter’s nerve entrapment can have a variety of causes, there’s no single way to prevent it completely. However, you can help reduce your risk by wearing well-fitted, supportive footwear as much as possible, particularly if you’re active or have a flatter foot posture. If you have orthotics from a podiatrist already, wearing these regularly can also help reduce your risk by optimising your foot posture. Managing any foot and ankle injuries before they progress and worsen can also help reduce your risk of further problems.

FAQs

Can Baxter's nerve entrapment heal on its own?

Baxter's nerve entrapment typically does not heal on its own where the cause is your existing foot posture or foot mechanics. While conservative measures like rest, ice, and anti-inflammatory medications can provide symptomatic relief, they may not address the root cause of the entrapment. This is where consulting your podiatrist is crucial to get you started on an effective recovery plan.

What long-term effects should I be aware of?

Long-term effects of Baxter's nerve entrapment depend on the severity of the condition. If left unmanaged, long-term effects may include persistent pain, limitations in mobility, and potential nerve damage. This means that your ability to stay active and keep doing the things you love comfortably and safely may be impacted.

When should I consult my podiatrist?

The earlier you start managing your symptoms and condition, the better the outcome. We recommend seeing your podiatrist when you start experiencing heel pain or swelling around the heel, if you’re experiencing neurological symptoms like numbness or burning, or if you’re having difficulty walking comfortably.