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Baxter's Neuritis

Posted by John h on 9/27/00 at 10:39 (029243)

i was reading a Podiatry publication and it was talking about a coming article on ' Baxter's Neuritis'. What is this? sounds like an inflamation of the baxter nerve of some sort. since this nerve runs under the fascia where most of us experience pf pain i am most interested in this. First time i have ever heard of this condition. Dr Baxter thinks most PF pain originates in the baxter nerve under the fascia to which his type of PF surgery addresses.

Re: Baxter's Neuritis

Barbara TX on 9/27/00 at 10:59 (029246)

John - I am VERY interested in this too. My pain runs along the fascia from heel to ball of foot - and it is a nervy sort of pain. My neurologist gave me the all clear - but I KNOW that I have some sort of nerve involvement such that when the plantar fascia is thickened and there is edema (my MRI showed this) the Baxter nerve is compressed. I am hoping that ESWT might resolve the problem. I know that some are worried about ESWT and nerve envolvement but I say just fry the thing along with the PF - if my whole foot was permanently numb at this point, I don't think I'd care. Let me know if you find anything else out about this condition. Caio, B.

Re: Baxter's Neuritis

john h on 9/27/00 at 11:10 (029249)

i have searched the net for 2 hours and cannot find anything on this condition. hope dr z subsribes to this publication.

Re: Baxter's Neuritis

Dr. Zuckerman on 9/27/00 at 12:22 (029254)

Could you tell me where you saw this upcoming article I would like to read about it. As you know I am fully aware of Dr. Baxter and his very thoughout theory for the branch of the lateral plantar nerve that sometimes pass directly under the pf medial band. I personally have ever seen this nerve. All of the open surgery that i was taught and have done was from the medial side of the foot. We placed and fingers inside the foot and felt for the heel spur. This was a very blind procedure. This is what made me look into a miminial incision approach from the bottom. Even from the bottom when we did an open procedure I never saw this nerve.

Re: Baxter's Neuritis

john h on 9/27/00 at 14:19 (029261)

it was on a podiatry publication website. i wll have to go back and find it. the articles i mentioned in the upcoming publication were 'baxter's neuritis' and 'heelspurs'.

Re: Baxter's Neuritis

john h on 9/27/00 at 14:44 (029263)

the upcoming issue of Podiatry Today will cover : best surgical approach for heel spur syndrome, how to diagnose and treat tarsal tunnel syndrome and the oft overlooked Baxter's neuritis, and treatment expertise for distinct classifications of posterior calcaneal pain. the url for Podiatry is http://www.podiatrytoday.com .
when the issue comes out you may be able to read these articles on the web site?

Re: Baxter's Neuritis

alan k on 9/27/00 at 20:34 (029285)

Wow.

I would really like to know more about this too.

Any preview info from anyone would be greatly appreciated.

I have nervy pain (well its not really pain anymore) too and normal pf procedures and explanations don't seem to have anything to do with it. Briefly I get mild sensations sometimes that are almost like classic pf but not quite.

I am also pursuing rheumatological explanations and will report if I get anywhere with that.

alan

Re: Baxter's Neuritis

Barbara TX on 9/27/00 at 23:10 (029297)

Alan - if your nervy feeling is less like pain, does that mean that you think you're seeing some improvement? Any numbness or weird sensations in your big toe? B.

Re: Please read if you have lots of questions about this

alan k on 9/28/00 at 09:42 (029306)

My history goes way back so new people with atypical symptoms might be interested:

My pain started after getting flu-like symptoms which were treated with anti-biotics as an infection. My wife also got this infection, if that is what it was, and was treated with antibiotics. We both developed achy feet, and were very active at the time and had been for years in a vigorous form of yoga. Our achy feet quickly became painful. She did get morning pain and classic syptoms but I didn't.

At my worst pain, I also had sensations extending into the toes, especially the big toe. Mostly it felt like pressure, like a balloon overfilled with air, sometimes there was tingling. But this was not too uncomfortable, but mostly just in the heel and around the sole anywhere that touches the ground. The arch, a little high, did not have much pain.

My wife became quickly better through exercise. I had to be careful with exercise and be extremely disciplined in not over doing it, and not underdoing it. Eventually all 'pain' was eliminated except for occasional set-backs which always followed a period of slacking off the foot exercises followed by sudden increase in activity. However, the achiness was never fully eliminated. I assumed it was bilateral tts, but I am very doubtful of that now.

So yes, severe pain definitely has gone and I live an almost completely normal life again, including doing yoga again which was the hardest thing for me to give up 1.5 years ago.

My most recent and longest set-back came while under chiropractic care and wearing 'massage sandals' in the shower. I stepped barefoot out of the massage sandals and felt a slight twinge in the heel. It was not painful, but came back from time to time during yoga, and eventually became a clear problem. I had to stop yoga and return to my exercises for a while. Now the interesting part: I went to the ESWT study in NY, a little too late because the twinge had cleared by the time my appointment came around. But after the treatment there was of course some swelling in the heel, and without a doubt the pressure feeling in the toes returned, especially the big toe. When swelling subsided, so did the sensation.

This is clear evidence to me that this pattern of pain could be due to swelling, edema, etc. and that is why I am so eager to hear what 'Baxter's neuritis' is, because perhaps it might shed some light on this. So far I can't find anyone who has heard of it though.

The other thing my wife and I are looking into is that 'infection' and the possibility of a rheumatic condition, since our hands and also my hip and bottom have been attacked as well, which matches the pattern of some diseases that escape normal rheumatism bloodwork.

In any case, everyne should realize that in every case people get better, at least considerably if not completely, and if you have an irregular pattern of symtoms this does not mean they will stay that way forever because they almost certainly will not. You just have to find the treatment that works for you.


alan k

Re: Please read if you have lots of questions about this

Terry on 9/28/00 at 10:00 (029310)

Alan K - If you have not already, you should consider drug-induced lupus and think about all the medicines that you have taken lately. I had it a year ago, and it was really bad. Terry

Re: Please read if you have lots of questions about this

Barbara TX on 9/28/00 at 10:39 (029314)

This is very reassuring, Alan - because I've been this way (with these weird atypical symptoms on top of the regular PF for about five months, and I am still searching. You give me hope that I can figure this out and this won't be permanent. I am so glad that you are still doing well and still visiting the boeard to be helpful and encouraging... I am promising myself to do the same once I am better! B.

Re: Please read if you have lots of questions about this

john h on 9/28/00 at 11:20 (029323)

dr z takes Podiatry Today so he will soon have the oct issue which covers Baxter's Neuritis. Neuritis means inflamation or lesioning of a nerve so it seems that Baxter's Neuritis is inflamation or lesioning of the baxter nerve which could certainly create some of the pain many of us experience. this nerve runs under the fascia near where it attaches to the heel. the questions that run through my mind is how do you diagnose it and how can you treat it. i remember my surgeon saying to me last year that the nerve under the fascia could be damaged! i assume he meant the baxter nerve.

another condition i ran across yesterday was 'plantar fascia fibromosis'. what is this?

Re: Please read if you have lots of questions about this

john a on 9/28/00 at 12:00 (029328)

It would seem to me that the 'atypical' PF many of us here have (including me), virtually screams 'Baxter's Neuritis', if my imaginative instincts are correct. By 'atypical', I mean calcaneal insertion point pain, no morning pain, and worsening pain the longer you are on your feet.

Plantar Fibromatosis is a thickening of the PF. Here is a short article describing it: http://www.chiroweb.com/archives/13/03/20.html

Re: Please read if you have lots of questions about this

john h on 9/28/00 at 12:19 (029329)

john a: it certainly screem Baxter's Neuritis to me. pressure on the baxter nerve can come from fluid (inflamation),tumor, vericose veins, pressure, and many other causes. it would seem that even improperly fitted orthotics could eventually cause a problem with the nerve. i have read that some drugs and improper diet can effect the nerve endings.

Re: Baxter's Neuritis

suzi on 9/28/00 at 22:34 (029379)

Dr. Baxter did my fascia release 4 years ago and found there was an entrapment of the first branch of the lateral plantar nerve.......the baxter nerve. Post surgery the nerve got re-entraped from scar tissue and after bugging him for years afterwards on what to do now, he only offered me a cortisone shot and suggested more surgery. Not a great outcome for me!

Re: getting better

alan k on 9/29/00 at 08:32 (029399)

I know it is scary and I was pretty depressed at the beginning, but everyone here gets significantly better. Some people plateau at some point.

If I knew I was going to be a little achy but able to do everything I love like yoga again, etc., back at my worst point, I would have been ecstatic. People on the message board at the time promised me I would get better but I didn't see it happening. I don't know if my promises will have any more effect on any of you beginners. But you will get better.

Nervy pain in the toes could be due to many things, so get it checked out. Doctors were not able to determine anything definitive at all about my condition whatsoever. They toyed with a tts diagnosis, but now that I have experienced temporary increased toe sensations after ESWT induced swelling, I am pretty sure I do not have tts, but some sort of nerve problem in relation to swelling or thickened fascia. I think we some of us may share something like this. Baxter's neuritis may or may not be the answer in every case, because I feel he focuses to narrowly on that one branch of the nerve and I think other branches could be effected as well.

Anyway, this definitely gets better. 'Pain' does not realy happen for me anymore, just achiness after a long time on the feet.


alan k

Re: Baxter's Neuritis

Barbara TX on 9/27/00 at 10:59 (029246)

John - I am VERY interested in this too. My pain runs along the fascia from heel to ball of foot - and it is a nervy sort of pain. My neurologist gave me the all clear - but I KNOW that I have some sort of nerve involvement such that when the plantar fascia is thickened and there is edema (my MRI showed this) the Baxter nerve is compressed. I am hoping that ESWT might resolve the problem. I know that some are worried about ESWT and nerve envolvement but I say just fry the thing along with the PF - if my whole foot was permanently numb at this point, I don't think I'd care. Let me know if you find anything else out about this condition. Caio, B.

Re: Baxter's Neuritis

john h on 9/27/00 at 11:10 (029249)

i have searched the net for 2 hours and cannot find anything on this condition. hope dr z subsribes to this publication.

Re: Baxter's Neuritis

Dr. Zuckerman on 9/27/00 at 12:22 (029254)

Could you tell me where you saw this upcoming article I would like to read about it. As you know I am fully aware of Dr. Baxter and his very thoughout theory for the branch of the lateral plantar nerve that sometimes pass directly under the pf medial band. I personally have ever seen this nerve. All of the open surgery that i was taught and have done was from the medial side of the foot. We placed and fingers inside the foot and felt for the heel spur. This was a very blind procedure. This is what made me look into a miminial incision approach from the bottom. Even from the bottom when we did an open procedure I never saw this nerve.

Re: Baxter's Neuritis

john h on 9/27/00 at 14:19 (029261)

it was on a podiatry publication website. i wll have to go back and find it. the articles i mentioned in the upcoming publication were 'baxter's neuritis' and 'heelspurs'.

Re: Baxter's Neuritis

john h on 9/27/00 at 14:44 (029263)

the upcoming issue of Podiatry Today will cover : best surgical approach for heel spur syndrome, how to diagnose and treat tarsal tunnel syndrome and the oft overlooked Baxter's neuritis, and treatment expertise for distinct classifications of posterior calcaneal pain. the url for Podiatry is http://www.podiatrytoday.com .
when the issue comes out you may be able to read these articles on the web site?

Re: Baxter's Neuritis

alan k on 9/27/00 at 20:34 (029285)

Wow.

I would really like to know more about this too.

Any preview info from anyone would be greatly appreciated.

I have nervy pain (well its not really pain anymore) too and normal pf procedures and explanations don't seem to have anything to do with it. Briefly I get mild sensations sometimes that are almost like classic pf but not quite.

I am also pursuing rheumatological explanations and will report if I get anywhere with that.

alan

Re: Baxter's Neuritis

Barbara TX on 9/27/00 at 23:10 (029297)

Alan - if your nervy feeling is less like pain, does that mean that you think you're seeing some improvement? Any numbness or weird sensations in your big toe? B.

Re: Please read if you have lots of questions about this

alan k on 9/28/00 at 09:42 (029306)

My history goes way back so new people with atypical symptoms might be interested:

My pain started after getting flu-like symptoms which were treated with anti-biotics as an infection. My wife also got this infection, if that is what it was, and was treated with antibiotics. We both developed achy feet, and were very active at the time and had been for years in a vigorous form of yoga. Our achy feet quickly became painful. She did get morning pain and classic syptoms but I didn't.

At my worst pain, I also had sensations extending into the toes, especially the big toe. Mostly it felt like pressure, like a balloon overfilled with air, sometimes there was tingling. But this was not too uncomfortable, but mostly just in the heel and around the sole anywhere that touches the ground. The arch, a little high, did not have much pain.

My wife became quickly better through exercise. I had to be careful with exercise and be extremely disciplined in not over doing it, and not underdoing it. Eventually all 'pain' was eliminated except for occasional set-backs which always followed a period of slacking off the foot exercises followed by sudden increase in activity. However, the achiness was never fully eliminated. I assumed it was bilateral tts, but I am very doubtful of that now.

So yes, severe pain definitely has gone and I live an almost completely normal life again, including doing yoga again which was the hardest thing for me to give up 1.5 years ago.

My most recent and longest set-back came while under chiropractic care and wearing 'massage sandals' in the shower. I stepped barefoot out of the massage sandals and felt a slight twinge in the heel. It was not painful, but came back from time to time during yoga, and eventually became a clear problem. I had to stop yoga and return to my exercises for a while. Now the interesting part: I went to the ESWT study in NY, a little too late because the twinge had cleared by the time my appointment came around. But after the treatment there was of course some swelling in the heel, and without a doubt the pressure feeling in the toes returned, especially the big toe. When swelling subsided, so did the sensation.

This is clear evidence to me that this pattern of pain could be due to swelling, edema, etc. and that is why I am so eager to hear what 'Baxter's neuritis' is, because perhaps it might shed some light on this. So far I can't find anyone who has heard of it though.

The other thing my wife and I are looking into is that 'infection' and the possibility of a rheumatic condition, since our hands and also my hip and bottom have been attacked as well, which matches the pattern of some diseases that escape normal rheumatism bloodwork.

In any case, everyne should realize that in every case people get better, at least considerably if not completely, and if you have an irregular pattern of symtoms this does not mean they will stay that way forever because they almost certainly will not. You just have to find the treatment that works for you.


alan k

Re: Please read if you have lots of questions about this

Terry on 9/28/00 at 10:00 (029310)

Alan K - If you have not already, you should consider drug-induced lupus and think about all the medicines that you have taken lately. I had it a year ago, and it was really bad. Terry

Re: Please read if you have lots of questions about this

Barbara TX on 9/28/00 at 10:39 (029314)

This is very reassuring, Alan - because I've been this way (with these weird atypical symptoms on top of the regular PF for about five months, and I am still searching. You give me hope that I can figure this out and this won't be permanent. I am so glad that you are still doing well and still visiting the boeard to be helpful and encouraging... I am promising myself to do the same once I am better! B.

Re: Please read if you have lots of questions about this

john h on 9/28/00 at 11:20 (029323)

dr z takes Podiatry Today so he will soon have the oct issue which covers Baxter's Neuritis. Neuritis means inflamation or lesioning of a nerve so it seems that Baxter's Neuritis is inflamation or lesioning of the baxter nerve which could certainly create some of the pain many of us experience. this nerve runs under the fascia near where it attaches to the heel. the questions that run through my mind is how do you diagnose it and how can you treat it. i remember my surgeon saying to me last year that the nerve under the fascia could be damaged! i assume he meant the baxter nerve.

another condition i ran across yesterday was 'plantar fascia fibromosis'. what is this?

Re: Please read if you have lots of questions about this

john a on 9/28/00 at 12:00 (029328)

It would seem to me that the 'atypical' PF many of us here have (including me), virtually screams 'Baxter's Neuritis', if my imaginative instincts are correct. By 'atypical', I mean calcaneal insertion point pain, no morning pain, and worsening pain the longer you are on your feet.

Plantar Fibromatosis is a thickening of the PF. Here is a short article describing it: http://www.chiroweb.com/archives/13/03/20.html

Re: Please read if you have lots of questions about this

john h on 9/28/00 at 12:19 (029329)

john a: it certainly screem Baxter's Neuritis to me. pressure on the baxter nerve can come from fluid (inflamation),tumor, vericose veins, pressure, and many other causes. it would seem that even improperly fitted orthotics could eventually cause a problem with the nerve. i have read that some drugs and improper diet can effect the nerve endings.

Re: Baxter's Neuritis

suzi on 9/28/00 at 22:34 (029379)

Dr. Baxter did my fascia release 4 years ago and found there was an entrapment of the first branch of the lateral plantar nerve.......the baxter nerve. Post surgery the nerve got re-entraped from scar tissue and after bugging him for years afterwards on what to do now, he only offered me a cortisone shot and suggested more surgery. Not a great outcome for me!

Re: getting better

alan k on 9/29/00 at 08:32 (029399)

I know it is scary and I was pretty depressed at the beginning, but everyone here gets significantly better. Some people plateau at some point.

If I knew I was going to be a little achy but able to do everything I love like yoga again, etc., back at my worst point, I would have been ecstatic. People on the message board at the time promised me I would get better but I didn't see it happening. I don't know if my promises will have any more effect on any of you beginners. But you will get better.

Nervy pain in the toes could be due to many things, so get it checked out. Doctors were not able to determine anything definitive at all about my condition whatsoever. They toyed with a tts diagnosis, but now that I have experienced temporary increased toe sensations after ESWT induced swelling, I am pretty sure I do not have tts, but some sort of nerve problem in relation to swelling or thickened fascia. I think we some of us may share something like this. Baxter's neuritis may or may not be the answer in every case, because I feel he focuses to narrowly on that one branch of the nerve and I think other branches could be effected as well.

Anyway, this definitely gets better. 'Pain' does not realy happen for me anymore, just achiness after a long time on the feet.


alan k