Heel Pain Isn’t Always Plantar Fasciopathy – Could It Be Baxter’s Neuropathy?
Understanding Heel Pain Beyond the Usual Diagnosis
Heel pain is one of the most common foot complaints we see at Neurohealth Wellness on the Northern Beaches of Sydney. Many people assume it must be plantar fasciopathy (often called plantar fasciitis), but that’s not always the case. If you've tried stretching, rolling your foot on a frozen water bottle, or even wearing orthotics without relief, it might be time to consider another cause—such as Baxter’s Nerve Entrapment (Baxter’s Neuropathy).
This often-overlooked condition mimics plantar fasciopathy but requires a different approach to treatment. Our chiropractors at Neurohealth Wellness, with their extensive understanding of biomechanics, nerve function, and rehabilitation, are trained to identify the root cause of your pain—so you get the right treatment, not just a temporary fix.
Many healthcare providers mistake one heel pain condition for another, leading to ineffective treatments. That’s why at Neurohealth Wellness, we dig deeper, ensuring an accurate diagnosis so you don’t waste time on therapies that don’t work.
What is Baxter’s Neuropathy?
Baxter’s neuropathy is a type of nerve entrapment where the first branch of the lateral plantar nerve becomes compressed. This nerve plays a key role in foot function and sensation. Unlike plantar fasciopathy, which involves inflammation of the plantar fascia ligament, Baxter’s neuropathy affects nerve function, leading to sharp, burning pain that often worsens with activity.
Common Causes of Baxter’s Neuropathy:
✔ Footwear issues – Tight shoes, hard soles, or excessive arch support that compresses the nerve
✔ Repetitive stress – Overuse from running, jumping, or prolonged standing
✔ Structural imbalances – Flat feet, high arches, or tight fascia compressing the nerve
✔ Scar tissue or inflammation – Previous injuries that have healed poorly, leading to nerve irritation
Since nerve entrapment is less commonly diagnosed, many people suffer for months or even years without the right treatment.
Is It Plantar Fasciopathy or Baxter’s Neuropathy?
One of the most common mistakes we see in people with heel pain is assuming that all heel pain is the same. If your pain hasn't improved with traditional plantar fasciopathy treatments like stretching, ice, orthotics, or shockwave therapy, it may be time to explore a different diagnosis.
Key Differences Between Conditions
Condition: Plantar Fasciopathy
Characteristics: First-step pain in the morning, eases with movement, worsens after rest.
Condition: Baxter’s Neuropathy
Characteristics: No first-step pain, worsens throughout the day, burning/shooting sensations, possible foot weakness.
Understanding these differences is crucial because the wrong treatment can delay recovery.
How We Diagnose Heel Pain at Neurohealth Wellness
A thorough assessment is the key to finding the root cause of your pain. At Neurohealth Wellness, we take the time to:
✔ Listen to your history – When did the pain start? Does it worsen with activity or after rest?
✔ Perform hands-on testing – Checking for muscle strength, nerve function, and foot biomechanics.
✔ Assess movement patterns – Looking at walking mechanics, foot posture, and compensations.
✔ Refer for imaging if needed – MRI can confirm nerve entrapment, especially if other conditions have been ruled out.
By taking a holistic approach, we can differentiate between plantar fasciopathy and Baxter’s neuropathy—leading to more effective treatment.
Treatment for Baxter’s Neuropathy at Neurohealth Wellness
Unlike plantar fasciopathy, Baxter’s neuropathy doesn’t respond well to stretching alone. Instead, treatment focuses on nerve decompression, improving biomechanics, and reducing inflammation.
Our Comprehensive Approach:
1. Chiropractic Adjustments & Joint Mobilisation
- Realigning the ankle, foot, and lower back to reduce pressure on the nerve.
- Addressing compensations in gait and movement that contribute to nerve irritation.
2. Soft Tissue Therapy & Dry Needling
- Targeted muscle release of the foot, ankle, and calf to relieve nerve entrapment.
- Dry needling to release tight fascia and trigger points contributing to nerve compression.
3. Neural Flossing & Movement Rehabilitation
- Nerve gliding exercises to help free the trapped nerve.
- Strengthening intrinsic foot muscles to support better foot mechanics.
4. Acupuncture for Pain Relief
- Our acupuncturist, Lucia, can assist in calming nerve irritation and reducing inflammation.
5. Footwear & Biomechanical Advice
- Avoiding excessive arch support, which can sometimes make nerve entrapment worse.
- Encouraging natural foot strengthening rather than over-reliance on orthotics.
Case Studies: Do Any of These Sound Like You?
Case 1: A Tradie with Persistent Heel Pain
A 26-year-old builder fell from a ladder, landing hard on his heel. His pain has lingered, but he has bruising and difficulty weight-bearing. This is likely a calcaneal stress fracture, not Baxter’s neuropathy.
Case 2: A Teacher with Morning Stiffness & Heel Numbness
A 58-year-old teacher with Crohn’s disease and psoriasis reports heel pain that’s worse at night and accompanied by numbness. This is likely an inflammatory arthritis, not Baxter’s neuropathy.
Case 3: A Marathon Runner with First-Step Pain
A 43-year-old runner with depression and anxiety reports first-step pain in the morning and no sensory changes. This is classic plantar fasciopathy, not nerve entrapment.
Case 4: A Retail Worker with Sharp, Burning Heel Pain
A 38-year-old retail worker stands for long hours and complains of burning heel pain that worsens throughout the day. She has tight footwear and a history of ankle sprains. This sounds like Baxter’s neuropathy!
Why Choose Neurohealth Wellness for Heel Pain?
At Neurohealth Wellness, we don’t just guess your diagnosis—we investigate it thoroughly. Whether you’re dealing with plantar fasciopathy, Baxter’s neuropathy, or another cause of heel pain, we provide:
✔ Comprehensive assessments to pinpoint the exact cause of your pain.
✔ Tailored hands-on treatment to get you moving pain-free.
✔ Holistic rehab plans so the pain doesn’t return.
✔ Education & support to empower you on your healing journey.
References
- Chundru, U., & Liebeskind, A. (2019). Baxter's Neuropathy: A Commonly Overlooked Cause of Heel Pain. Foot & Ankle Specialist, 12(3), 209–215.
- Tu P., & Bytomski, J. (2011). Plantar fasciitis and other causes of heel pain. American Family Physician, 84(8), 909-916.
- Govindarajan, P., et al. (2022). Differentiating between plantar fasciopathy and nerve-related heel pain. Journal of Foot and Ankle Research, 15(1), 45.
- Barrett, S. L., & O'Malley, R. (2014). Compression neuropathy of the first branch of the lateral plantar nerve (Baxter’s nerve). Clinics in Podiatric Medicine and Surgery, 31(3), 409–425.
- Magee, D. J. (2020). Orthopedic Physical Assessment. Elsevier Health Sciences.
If you’re struggling with heel pain, don’t let it hold you back. Book an appointment today with one of our expert chiropractors and take the first step toward lasting relief.
📍 Neurohealth Wellness – Northern Beaches, Sydney
📞 (02) 9905 9099📅 Book Online Now
Final Thoughts: Not All Heel Pain is the Same
❌ Not every heel pain case is plantar fasciopathy.
❌ Not everyone needs orthotics or shockwave therapy.
✅ A proper diagnosis leads to the right treatment.
If you’ve been suffering from heel pain with little improvement, let us help you uncover the real cause. Whether it’s nerve entrapment, inflammation, or biomechanics, our team is ready to support your recovery.
Move pain-free. Stay active. Get back to life.
