Baxter's nerve: the hidden culprit of chronic heel pain

Baxter's nerve entrapment, an underrecognized cause of medial plantar heel pain, is frequently misdiagnosed as plantar fasciitis, leading to inadequate treatment. This condition involves compression of the first branch of the lateral plantar nerve, often resulting in chronic, burning pain with neurological symptoms. Despite accounting for up to 20% of chronic heel pain cases, clinical awareness remains low, delaying diagnosis and management. Differential diagnosis from plantar fasciitis, tarsal tunnel syndrome, and calcaneal stress fractures is crucial. High-resolution ultrasound, electromyography, and targeted clinical evaluation improve diagnostic accuracy. Management includes conservative interventions such as physical therapy, orthotics, and neuromodulation, with interventional options like corticosteroid injections and surgical decompression reserved for refractory cases. Increasing clinician awareness and integrating advanced imaging into routine practice are essential for improving patient outcomes.