What could be my problem?

Entrapment Neuropathy sometimes referred to as Baxter’s Nerve Entrapment results from compression of a nerve that supplies the plantar (under) surface of your foot. This nerve is also known as the inferior calcaneal nerve.

Plantar Fasciitis and Baxter’s Nerve are sometimes confused due to the similarity or the location of pain. In Baxter’s Nerve Entrapment distinct tenderness is felt at the origin of the abductor hallicus muscle (a small muscle along the inside of the foot), whereas the most intense site of pain in Plantar Fasciitis is more commonly towards the bottom of the heel.

Unlike Plantar Fasciitis, pain associated with entrapment tends to get worse with physical activity. Pain is more localized and it is pressure sensitive. Custom shoe orthotics may aggravate the pain if they have been prescribed to address a different diagnosis due to the orthotic further compressing the nerve.

What causes Entrapment Neuropathy?

• When the nerve becomes entrapped between two muscles, the abductor halluces and the quadratus plantar, located along the lower aspect of the inside (medial-plantar) of the heel.
• When the nerve becomes compressed against the heel bone on the under (plantar) side of the foot. Heel Spurs (calcaneal plantar enthesophyte) and swelling of the plantar fascia may contribute to nerve entrapment at this location.

When to see a foot pain specialist about heel pain:

• Numbness and/or pain of the plantar heel
• Dull ache of the bottom and lateral aspect of the heel
• No pain with initial weight bearing on foot, but pain increases with the duration of time spent on the feet.

What are my treatment options?

Non-Surgical Treatment Options for Entrapment Neuropathy include:

• Rest
• Cold therapy
• Physical therapy
• Custom orthotics: to address causative biomedical factors such as flat feet, over pronation.
• Injection therapy: local anesthetic and corticosteroid

Surgical Treatment Options: 

When pain levels fail to improve with conservative treatment or cease for a short time after injection therapy only to return, surgery for Baxter’s Nerve Entrapment known as neurolysis may be indicated and may also be combined with a plantar fascia release.