One of the most frequent, and often debilitating, condition that occurs in the foot is heel pain. The most common cause of heel pain is plantar fasciitis, however, nerve entrapment and stress fractures may also be implicated. A correct diagnosis from the outset is essential to ensure a quick resolution. Bio Podiatry’s team have the knowledge and skills to make that correct diagnosis, ensuring the correct treatment plan is instigated

Baxter’s nerve entrapment – A small nerve branch on the bottom of the foot runs just under the plantar fascia and in certain situations can become entrapped. This nerve is called Baxter’s nerve and is a small branch that leads off one of the two main nerves on the bottom of the foot.

It can become caught, and subsequently entrapped under the plantar fascia or in some lesser situations under a small muscle belly on the inside of the foot. This muscle belly is the abductor hallucis.

We, at Bio Allied Health, assess every patient who presents with plantar heel pain to ensure a correct diagnosis is made. If Baxter’s nerve entrapment is diagnosed, the treatment can be different to the more common plantar fasciitis and a focus must be tuned to this condition to ensure pain relief occurs.

Stress fracture of the calcaneus – A much lesser occurring condition is the calcaneal stress fracture (broken heel bone). This condition is in fact is relatively rare. It typically occurs when a runner suddenly increases their running distance or when someone decides to take up running and does not allow the bone to become strong enough to take the forces that are placed on this large and important bone. It is commonly known as doing “too much, too soon”.

Our podiatrists will review the foot and may request certain medical imaging if a stress fracture is suspected. Again, the treatment is very different to the one for plantar fasciitis and hence must be kept in mind when assessing a painful heel.

Plantar fasciitis – Plantar fasciitis is a condition whereby a structure on the bottom of the foot known as the plantar fascia is excessively strained and stretched, leading to tiny partial tears that result in inflammation and pain. Common causes of plantar fasciitis are overuse, certain sports and activities. However, a foot that flattens out (excess pronation) can lead to the plantar fascia being excessively stretched and damaged.

Treatment for plantar fasciitis is typically multi-faceted and includes stretching, strengthening, manual therapy, ice, orthotics, gel pads and shockwave therapy. The aim is to eradicate the pain, allow the plantar fascia to heal and permit a full return to activities. If pain persists then corticosteroid injections can be given.

Plantar fasciosis – If plantar fasciitis has been present for many months and has been resistant to treatment attempts, the condition can subtly change and develop into plantar fasciosis. This is often missed by podiatrists and physiotherapists.

Assessing this differentiation is key, as the treatment for plantar fasciosis is subtly different from the original plantar fasciitis. At Bio Podiatry, we are trained to differentiate the various conditions, make the correct diagnosis and ensure the most appropriate treatment modality is chosen.