Baxter's Nerve Entrapment: Understanding and Treating Heel Pain

Heel pain is a frequent issue experienced by many people and seen by chiropractors, often attributed to plantar fasciitis (PF). However, it's crucial to consider other potential causes like Baxter's neuropathy. This condition, also known as Baxter's nerve entrapment, mimics PF but requires a different approach for diagnosis and treatment. 

Studies show that 88% of patients with heel pain have degenerative findings in the lateral plantar nerve using nerve conduction velocity, suggesting neural involvement in heel pain. Additionally, approximately 54% of patients with plantar foot pain have a neurological cause. Heel pain that occurs at night or with the first step in the morning may indicate a neural origin rather than plantar fasciitis.

Baxter's Neuritis: Where is it located and what are the symptoms?

Nerve entrapments can lead to acute or chronic conditions affecting the heel. The first branch of the lateral plantar nerve, known as Baxter's nerve, is often involved in heel pain. This nerve courses between certain foot muscles, contributing to pain in the bottom and inside of the heel.

Baxter's Neuropathy VS Plantar Fasciitis

Unlike Plantar Fasciitis, Baxter's neuropathy presents with additional symptoms like numbness, tingling, or radiating pain into the foot's arch. Pain from Baxter's neuropathy is typically localized to the bottom and inside of the heel and may worsen with weight-bearing activities, persisting even after rest.

Chiropractic Treatment Approaches

Unlike the straightforward management of Plantar Fasciitis, Baxter's neuropathy requires a multidisciplinary approach. Treatment may involve rest, activity modification, orthotic devices, and specific mobilisation techniques targeting the ankle and foot. In severe cases, surgical intervention may be necessary.

Baxter's neuropathy poses a diagnostic challenge due to its similarities with PF. Chiropractors must recognize its distinct features and use appropriate tests for accurate diagnosis. By employing a comprehensive treatment approach, including conservative and surgical options, chiropractors can effectively manage Baxter's neuropathy, improving patient outcomes and quality of life.