Baxter nerve entrapment is a cause of heel pain with the symptoms often mimicking plantar fasciitis and should be conisdered in any case of heel pain the has a neurological component to it.

Baxter’s nerve entrapment, also known as inferior calcaneal nerve entrapment, is a relatively common but often overlooked cause of chronic heel pain. The Baxter’s nerve is the first branch of the lateral plantar nerve, and it runs beneath the abductor hallucis muscle before traveling along the medial side of the heel. Because of its position, it is vulnerable to compression as it passes between surrounding structures, particularly the abductor hallucis and the medial calcaneal tuberosity. This entrapment can mimic or coexist with plantar fasciitis, which is why it is frequently misdiagnosed.

The clinical presentation of Baxter’s nerve entrapment usually involves sharp, burning, or radiating pain on the inside of the heel that may worsen with prolonged standing, walking, or running. Unlike classic plantar fasciitis, which is typically most painful during the first steps in the morning, Baxter’s nerve pain can persist throughout the day and sometimes worsens with activity. Patients may also report tingling or numbness along the heel or arch, as the compressed nerve is both sensory and motor. Chronic cases can even lead to weakness of the abductor digiti quinti muscle in the foot.

Risk factors and causes often include repetitive overuse in runners, foot deformities such as flat feet or overpronation, and tightness of the abductor hallucis muscle. External factors, like ill-fitting shoes or excessive standing on hard surfaces, can also contribute to entrapment. In many athletes, the combination of repetitive heel impact and biomechanical stress creates a perfect environment for irritation of the nerve. Because these symptoms overlap with plantar fasciitis, imaging such as MRI or ultrasound, along with careful physical examination, is usually needed to confirm the diagnosis.

Treatment strategies for Baxter’s nerve entrapment focus on reducing nerve compression and inflammation. Conservative options include rest, orthotic devices to correct foot mechanics, stretching of the calf and abductor hallucis, and targeted physical therapy. Anti-inflammatory medications or corticosteroid injections may be used in persistent cases. For patients who do not respond to conservative care, surgical decompression of the nerve can be considered, which generally provides significant relief. Early recognition is important, as untreated entrapment can lead to chronic heel pain and functional limitations.

Most Useful Resources:
Baxters Nerve Entrapment (PodiaPaedia)
Baxter’s Neuritis (Medial Calcaneal Nerve Neuritis) (Podiatry Arena)
Baxter’s neuropathy secondary to plantar fasciitis (Podiatry Arena)
Baxters Nerve Entrapment (Podiatry TV)
Baxters nerve or plantar fasciitis? (Podiatry Experts)
Baxters Nerve Entrapment (Foot Health Forum)