Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

question about the Baxter nerve...

Posted by Sue R on 8/29/00 at 07:41 (026579)

I've heard a lot about problems with the Baxter nerve. My pain is currently about one inch forward of the heel in the arch area. Last week it was all along the fascia in the arch so it's a little better this week. Does this sound like it could be related to the Baxter nerve? Any ideas? My heels aren't bad now, except for when I really push on my left one. I don't know what all this means but would sure appreciate any advice you could give me.

Thanks,
Sue R

Re: the Baxter nerve...

Dr. Biehler on 8/29/00 at 12:19 (026605)

If I remember right, the baxter nerve is just another name for the later branch of the calcaneal nerve. This nerve runs right above the medial calcanial tubercal inbetween the where a heel spur would be and the heel bone. It is therorised that when a person has plantar fasciitis, fluids build up around this nerve when the person is at rest. When they take their first step the fluid can not move out of the area fast enough so there is preasure on this nerve that causes the 'first step pain' that so many people are familar with. If your pain is farther forward, it is probably not the baxter nerve that is the problem. Dr. Biehler

Re: the Baxter nerve...

Sue R on 8/29/00 at 13:29 (026612)

So what do you think the problem could be? Any guesses?

I have extremely high arched, narrow, flexible feet. This is my second go-around with pf. I tested negative on nerve tests, have seen podiatrist who gave me orthotics (too rigid for me to wear right now), ortho surgeon, PT, and now pain management person specializing in holistic medicine. I ran 10 years ago before the initial onset and didn't ever get completely pain-free (no barefoot and careful about shoes) but able to function great. I was back to speed walking when pf broke loose again on May 1.

My pain is primarily in the arch and I rest, ice, stretch (slowly now), and am on Elavil. I don't do any shopping or errands, just home with the kids or at work (desk job). This is getting very old!

Thanks for any advice you can give me.

Sue R

Re: the Baxter nerve...

Dr. Zuckerman on 8/29/00 at 16:45 (026637)

How about pt with a boot cast in between.????

Re: the Baxter nerve...

Dr. Biehler on 8/29/00 at 18:08 (026648)

The narrow, high arch flexible foot reminds me of of the typical calcanial varus foot ( thats where the heel is slightly turned medialy). In these feet if there is not enough motion in the subtaylor joint, it causes the fore foot to twist in order for it it plant itself flat on the ground for toe off in the gait cycle. This twisting causes pain in the arch. I don't think it is uncommon to only find this symptomatic in only one foot. A small posting which could be a 1/8' felt ( or more if needed) pad under the medial side of the forefoot is sometimes all that is needed to take the pressure off the arch an allow it to heal. Dr. Biehler

Re: the Baxter nerve...

JudyS on 8/29/00 at 19:19 (026659)

Dr. B - your description here sounds exactly like what I've been dealing with. My current PT recognized that toe-off problem right away and even put it in to chicken/egg language. Which came first, that stride problem or the PF? Our work these last weeks has greatly reduced the secondary problem I'd developed in that big-toe muscle (can't say it's name!) and my heel/arch pain is showing real signs of improvement. I've printed your paragraph to show the PT and the Pod and I sincerely hope it makes as much sense to them as it does to me. With all due respect to the professionals, sometimes I wonder if they don't see beyond the generic assumptions about PF. I'll be asking about the reasonableness of altering my orthotics - or using your method. Thank you!

Re: To Dr. B....the Baxter nerve...

Sue R on 8/30/00 at 07:44 (026718)

I am currently in NB 990's with a thick insert (over the counter) that has pretty good arch support...probably not enough though. I can't wear my rigid custom made ones. Where would this felt go? I don't understand.

Please help!

Sue R

Re: To Dr. B....the Baxter nerve...

Dr. Biehler on 8/30/00 at 08:15 (026721)

If the insert is removable, take it out and then on the insert you put the felt. The felt will be on the big toe side of the insert. It should be thick at the medial edge and taper to about 1/2 way across the insert.. If you were able to hold you foot in a subtaylor joint neutral position the forefoot should be flat on the ground. If it is not, this is a way to' bring the ground' up to the foot to reduce the excessive twisting motion. Dr. Biehler

Re: To Dr. B......the Baxter nerve...

Sue R on 8/30/00 at 08:51 (026722)

I've already been to PT...they didn't see anything wrong with my gait other than my foot position. If I turn my body all the way to one side while standing forward, that's how my foot position should be when I walk. The PT didn't seem to think this could be causing as great of a problem as I have. She said I do need orthotics but I can't wear the rigid things right now. She want me to see this Pain Specialist to try to 'stop the cycle' before coming back for maybe some ultrasound treatment. No other real problem.

What do you think? Remember I'm the one with the high arch, narrow, flexible feet. I've been through this 10 years ago and it eventually got better (not 100% though). My pain is in the arch primarily.

Help!

Sue R

Re: the Baxter nerve...

Dr. Biehler on 8/29/00 at 12:19 (026605)

If I remember right, the baxter nerve is just another name for the later branch of the calcaneal nerve. This nerve runs right above the medial calcanial tubercal inbetween the where a heel spur would be and the heel bone. It is therorised that when a person has plantar fasciitis, fluids build up around this nerve when the person is at rest. When they take their first step the fluid can not move out of the area fast enough so there is preasure on this nerve that causes the 'first step pain' that so many people are familar with. If your pain is farther forward, it is probably not the baxter nerve that is the problem. Dr. Biehler

Re: the Baxter nerve...

Sue R on 8/29/00 at 13:29 (026612)

So what do you think the problem could be? Any guesses?

I have extremely high arched, narrow, flexible feet. This is my second go-around with pf. I tested negative on nerve tests, have seen podiatrist who gave me orthotics (too rigid for me to wear right now), ortho surgeon, PT, and now pain management person specializing in holistic medicine. I ran 10 years ago before the initial onset and didn't ever get completely pain-free (no barefoot and careful about shoes) but able to function great. I was back to speed walking when pf broke loose again on May 1.

My pain is primarily in the arch and I rest, ice, stretch (slowly now), and am on Elavil. I don't do any shopping or errands, just home with the kids or at work (desk job). This is getting very old!

Thanks for any advice you can give me.

Sue R

Re: the Baxter nerve...

Dr. Zuckerman on 8/29/00 at 16:45 (026637)

How about pt with a boot cast in between.????

Re: the Baxter nerve...

Dr. Biehler on 8/29/00 at 18:08 (026648)

The narrow, high arch flexible foot reminds me of of the typical calcanial varus foot ( thats where the heel is slightly turned medialy). In these feet if there is not enough motion in the subtaylor joint, it causes the fore foot to twist in order for it it plant itself flat on the ground for toe off in the gait cycle. This twisting causes pain in the arch. I don't think it is uncommon to only find this symptomatic in only one foot. A small posting which could be a 1/8' felt ( or more if needed) pad under the medial side of the forefoot is sometimes all that is needed to take the pressure off the arch an allow it to heal. Dr. Biehler

Re: the Baxter nerve...

JudyS on 8/29/00 at 19:19 (026659)

Dr. B - your description here sounds exactly like what I've been dealing with. My current PT recognized that toe-off problem right away and even put it in to chicken/egg language. Which came first, that stride problem or the PF? Our work these last weeks has greatly reduced the secondary problem I'd developed in that big-toe muscle (can't say it's name!) and my heel/arch pain is showing real signs of improvement. I've printed your paragraph to show the PT and the Pod and I sincerely hope it makes as much sense to them as it does to me. With all due respect to the professionals, sometimes I wonder if they don't see beyond the generic assumptions about PF. I'll be asking about the reasonableness of altering my orthotics - or using your method. Thank you!

Re: To Dr. B....the Baxter nerve...

Sue R on 8/30/00 at 07:44 (026718)

I am currently in NB 990's with a thick insert (over the counter) that has pretty good arch support...probably not enough though. I can't wear my rigid custom made ones. Where would this felt go? I don't understand.

Please help!

Sue R

Re: To Dr. B....the Baxter nerve...

Dr. Biehler on 8/30/00 at 08:15 (026721)

If the insert is removable, take it out and then on the insert you put the felt. The felt will be on the big toe side of the insert. It should be thick at the medial edge and taper to about 1/2 way across the insert.. If you were able to hold you foot in a subtaylor joint neutral position the forefoot should be flat on the ground. If it is not, this is a way to' bring the ground' up to the foot to reduce the excessive twisting motion. Dr. Biehler

Re: To Dr. B......the Baxter nerve...

Sue R on 8/30/00 at 08:51 (026722)

I've already been to PT...they didn't see anything wrong with my gait other than my foot position. If I turn my body all the way to one side while standing forward, that's how my foot position should be when I walk. The PT didn't seem to think this could be causing as great of a problem as I have. She said I do need orthotics but I can't wear the rigid things right now. She want me to see this Pain Specialist to try to 'stop the cycle' before coming back for maybe some ultrasound treatment. No other real problem.

What do you think? Remember I'm the one with the high arch, narrow, flexible feet. I've been through this 10 years ago and it eventually got better (not 100% though). My pain is in the arch primarily.

Help!

Sue R