Diagnosing a Baxters Nerve Entrapment
This can be challenging and often mimic plantar fasciitis, and can actually be caused by plantar fasciitis. Baxters neuritis is an entrapment of a branch of the lateral plantar nerve that innervates the abductor digiti minimi muscle. It has been claimed that up to 20% of cases of heel pain may be due to this.
Clinically the distinction between a Baxters nerve entrapment and plantar fasciitis is not clear, especially in the early stages. Usually the tenderness is more over the origin of the abductor hallucis muscle which may radiate laterally. Sometimes there are a slight parathesiaes present. Phalen’s maneuver may also elicit pain: this is done by inverting and plantarflexing the foot which will compress the nerve, due to narrowing of the porta pedis at the superior margin of the abductor hallucus muscle. Many patients also lose the ability to abduct the fifth digit (but some people can’t do this anyway!). They also tend not to have the poststatic dyskinesia that typical in plantar fasciitis unless it is also present. They also tend to describe a more radiating pain.
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