What is Baxter’s neuritis?
Baxter’s nerve entrapment (also known as Baxter’s neuritis, Baxter’s neuropathy, or calcaneal nerve entrapment) typically presents as plantar heel pain or discomfort on the bottom of the foot near the heel.
It is often mistaken for other common causes of heel pain, such as a stress fracture or plantar fasciitis. However, the actual source of the pain is an entrapped Baxter’s nerve.
Baxter’s neuritis occurs when a branch of the tarsal tunnel nerve becomes trapped or scarred. Baxter’s nerve (the inferior calcaneal nerve) is the first branch of the lateral plantar nerve before it continues through the arch of the foot. This small nerve can become pinched between muscles in the ankle. The quadratus plantae and abductor hallucis muscles often trap or pinch this small nerve.
Baxter’s neuropathy can be overlooked as a source of heel pain since many other conditions can lead to similar discomfort. Approximately 20% of the time, patients visit Dr. Bob Baravarian after being misdiagnosed with plantar fasciitis. Chronic heel pain may also be incorrectly attributed to heel spurs, Morton’s neuroma, flat feet, or an injury to the heel bone (calcaneus).
What are the symptoms of Baxter’s neuritis?
When the Baxter nerve is pinched, it often causes pain and discomfort. Other symptoms of Baxter nerve entrapment can include:
- Sharp medial-plantar heel pain, which is often mistakenly considered to be plantar fasciitis.
- A burning sensation around the inner ankle and heel area.
- Loss of sensation or pins and needles (paresthesia) at the base of the foot or under the heel.
- Discomfort during weight-bearing activities
- Experiencing pain first thing in the morning when getting out of bed or after resting.
- Sensitivity to touch on the inside of the heel
What causes Baxter’s nerve entrapment?
So far, no single cause of Baxter’s nerve entrapment has been identified. It can develop over time, regardless of age or gender. In some instances, it may result from an injury to the foot or ankle. Over-pronation (rolling your foot inwards when walking), obesity, and flat feet can increase your risk of developing nerve entrapment.
Wearing overly tight shoes and incorrectly fitting orthotics can also heighten your risk.
How is Baxter’s nerve compression diagnosed?
Because heel pain can have numerous possible causes, it’s essential to consult a foot and ankle specialist for a proper diagnosis. The podiatrists at Dr. Bob Baravarian have access to imaging technology and neurosensory testing to rule out bone spurs, stress fractures, and issues with the muscles, ligaments, and tendons.
Imaging techniques like X-rays and MRIs also allow Dr. Bob to see where the nerve is being pinched.
Conservative treatment options for calcaneal nerve entrapment
Non-surgical treatment options focus on relieving pain and reducing inflammation and swelling that can further irritate the nerve. Conservative treatment often includes
Corticosteroid injections near the nerve
Steroid injections can be particularly helpful when over-the-counter NSAIDs are ineffective. Physical therapy, taping, and possibly bracing for a period may also be recommended. Custom insoles, known as orthotics, may be used to alleviate chronic pain along the affected nerve.
Cryotherapy
This outpatient treatment method, which uses extreme cold to remove Baxter’s nerve, is sometimes used to alleviate nerve pain symptoms without surgical intervention. A 2-millimeter incision is made, and the cryoprobe freezes the damaged nerve under local anesthesia. You can return to regular shoes after about three days and resume full activity after approximately two weeks.
In about 30% of cases, it may be necessary to repeat the procedure to achieve an ideal outcome.
Amniotic Stem Cell Injection
These can be used to inject the area of nerve entrapment, alleviating the pain associated with nerve compression by reducing swelling and minimizing damage to the nerve tissue. This injection is performed in the office under ultrasound guidance and achieves a high success rate without the need for surgery.
Is there a surgical treatment option for Baxter’s nerve entrapment?
Yes, it is called decompression. Decompression, a surgical release of the nerve, may be necessary if your pain does not improve with our conservative treatment options. Performed in an outpatient setting, this procedure offers a relatively quick recovery. Typically, the nerve is released as part of a more extensive release of fascia and ligaments.
This procedure may be necessary in cases where innervation to the abductor digiti minimi muscle is crucial for restoring the sensation and function of the little toe, as well as for preventing atrophy.
Patients cannot bear weight on the foot for approximately two weeks, after which they will begin physical therapy to restore strength and flexibility.
Why is Dr. Baravarian the best foot and ankle specialist for treating Baxter nerve pain in Los Angeles?
Dr. Bob has decades of experience treating all forms of adult foot and ankle concerns. He uses the latest technologies available to diagnose and treat Baxter’s neuropathy successfully.
New patients or individuals concerned about foot or toe pain in the greater Los Angeles area are encouraged to call or schedule a consultation. Please call (855) 557-5400 or make an appointment now.
Dr. Bob Baravarian is conveniently located in Los Angeles, near Cedars-Sinai Medical Center, providing expert foot and ankle care for patients throughout Southern California.
Baxter’s Neuritis FAQs
What does Baxter’s nerve pain feel like?
Baxter’s nerve pain is often described as sharp or burning. It may also lead to loss of sensation, numbness, and a pins-and-needles feeling. The pain occurs on the bottom of the heel and is frequently misdiagnosed as plantar fasciitis.
What are the best shoes for Baxter’s nerve entrapment?
Shoes that provide good arch support and absorb shock can be helpful for Baxter’s nerve entrapment. Orthotics tailored to your foot mechanics and shape may also offer benefits.
Baxter’s nerve entrapment vs. plantar fasciitis, what’s the difference?
It can be challenging to distinguish between plantar fasciitis and Baxter’s neuropathy. However, plantar fasciitis pain typically arises where the plantar fascia attaches to the heel, while Baxter’s nerve entrapment can cause symptoms further from the heel and closer to the inner ankle.
