Baxter's Nerve Entrapment

Baxter's nerve entrapment, also known as Baxter neuropathy, is plantar heel pain arising from compression of the inferior calcaneal nerve (Baxter nerve).

Anatomy

Baxter nerve (Nerve to abductor digiti quinti).

The inferior calcaneal nerve (Baxter nerve) is the first branch of the lateral plantar nerve, which is itself a branch of the tibial nerve. The nerve lies in between the abductor hallucis muscle and quadratus plantae.

The Gray's anatomy image and many other anatomy textbook images are incorrect. The Baxter nerve is quite posterior and lies very close to the calcaneus.

Classification

There are three entrapment points:

Tarsal tunnel syndrome is a related condition but involves entrapment more proximally in the tarsal tunnel.

Epidemiology and Risk Factors

Obesity, diabetes.

Clinical Features

The clinical features may be similar to or coexist with plantar fasciitis. However there may be less morning pain, occasional altered sensation, and intrinsic muscle atrophy.

Differential Diagnosis

Differential Diagnosis of Heel Pain

• Plantar Fasciitis
• Fat Pad Contusion
• Calcaneal fractures (traumatic and stress)
• Inferior Calcaneal (Baxter) Nerve Entrapment
• Medial Calcaneal Nerve Entrapment
• Lateral Plantar Nerve Entrapment
• Medial Plantar Nerve Entrapment
• Tarsal Tunnel Syndrome
• Lumbar Radicular Pain
• Talar stress fracture
• Retrocalcaneal bursitis
• Spondyloarthritis
• Osteoid osteoma
• CRPS

Treatment

Baxter's nerve Sd. Procedure: corticosteroid injection & orthotics. Good result. @Dr_Ramon_Balius #MSKUltrasound pic.twitter.com/ED9RcmqJnz

— Ramon Balius (@Dr_Ramon_Balius) March 21, 2016