One cause of chronic heel pain that is often overlooked is a condition known as Baxter’s nerve entrapment. This condition can cause similar symptoms to plantar fasciitis—making it difficult to obtain a correct diagnosis. A peripheral nerve surgeon such as Dr. Williams can diagnose the condition and recommend treatment options.
Symptoms of Nerve Entrapment
The Baxter’s nerve is a small nerve in the bottom of the foot that is the first part of the lateral plantar nerve inside of the heel. It is responsible for sending sensations to the heel and the smaller muscles of the foot. When the Baxter’s nerve becomes compressed or entrapped, it can cause the following symptoms:
- Tingling sensation
- Heel tenderness
- Foot or ankle weakness
- Sharp or burning pain
While Baxter’s nerve entrapment can cause similar symptoms to plantar fasciitis, one difference is the timing of the pain. With plantar fasciitis, the pain is often worse in the morning when stepping out of bed. This is not the case with Baxter’s nerve entrapment. The pain is often worse at the end of the day after activities.
Baxter’s nerve entrapment is responsible for 20% of chronic heel pain cases. Since the condition is often overlooked and misdiagnosed as plantar fasciitis, it is common for treatment to be delayed and the pain to last for months or even years. To determine what is causing the pain, imaging tests such as an MRI or ultrasound may be done to evaluate the Baxter’s nerve.
There are a variety of treatment options to consider for Baxter’s nerve entrapment. These can include taping and custom orthotics. In addition, exercises that strengthen and stretch the foot can often help with reducing symptoms. For chronic pain in the heel that lasts for over six months, the following treatments may be recommended:
- Injection. An ultrasound-guided injection of cortisone may help reduce pain and inflammation in the Baxter’s nerve.
- Surgery. Nerve decompression surgery may be needed to release the entrapped nerve that is causing the pain and symptoms.
To schedule an appointment with Dr. Williams in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.