When the Nerve, Not the Fascia, Is the Problem
A subset of patients with heel pain have entrapment of the first branch of the lateral plantar nerve (Baxter’s nerve) rather than - or in addition to - plantar fasciitis. They typically have pain at the medial heel, sometimes with a burning or radiating quality, that hasn’t responded to fascia-directed treatment.
Diagnosis
Careful clinical exam, sometimes with diagnostic nerve block, and selective imaging.
The Procedure
Targeted decompression of the entrapped nerve through a small medial incision. Walking boot for 1–2 weeks, progressive return to activity over 4–8 weeks. Pain relief in well-selected patients is high.