Heel pain and the Baxter’s Nerve

Courtesy: Prof Nabile Ebraheim, University of Toledo, United States. Multimedia presentation involving The causes of heel pain; compression of the Baxter’s nerve, fatpad atrophy, plantar fasciitis, achilles tendinitis, stress fractures of the Calcaneus.

The video describes common causes of heel pain,which includes Baxters nerve(First branch of lateral plantar nerve)compression, Plantar fascitis,Fat pad atrophy,Achilles tendonitis,Stress fracture of the calcaneus and Lumbar spine radiculopathy(L5-S1).Site of pain in all these conditions are closer and hence difficult to distinguish. Plantar fascitis(inflamation of thick fascia on the plantar aspect )causes severe heel pain in the morning and relived by walking,there will be medial calcaneal tuberosity tenderness.Fat pad atrophy is thinning of muscle cushion of feet associated with elderly patients. Chronic injury to achilles tendon may leads to achilles tendinitis and patient will have painful walk.Stress fractures are due to repititive stress,commonly seen in patients involved in running sports and presents with weight bearing pain.In lumbar spine radiculopathy they have pain over lateral side of foot. Baxter’s nerve supplies motor innervation to abductor digiti minimi and it can compressed with in medial heel which cause heel pain,paresthesia and abnormal sensations over the plantar aspect of heel.Management of heel pain is usually conservative which include heel strecthing exercise,NSAIDS,rest and orthotics. Surgical decomoression of nerve is the last resort in entrapment neuropathy of baxters nerve.