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Podiatrist (General)
It is always best to explore all conservative options for heel pain before looking at surgery.
Acupuncture may be of some assistance, but it is usually of temporary benefit.
I would suggest immobilisation of the foot and ankle in a removable cast walker for 6-8 weeks to allow the nerve to settle. Alternatively, a local anaesthetic +/- corticosteroid injection to bathe the nerve may assist in breakdinw the pain cycle.
Surgical release is usually the best long term solution if all other conservative options have failed.
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I am also having the same problem. Have entrapment of Baxters Nerve on my right heel. I was advised to try wearing general orthodics for 6 weeks to see if symptons decline but they haven't at all. The next step my podiatrist suggested would be to get the sterioid anathetic injection. I hate injections. The next step if that doesn't work would be surgery. So I'm interested to look further in shockwave therepy. Is this a treatment that is easily accessable? I'm in Melbourne.
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Podiatric Surgeon, Podiatrist (General)
I agree that it is important to exhaust conservative treatment options prior to having surgery for this condition, and most people with Baxter's nerve entrapment improve with orthotics, guided-steroid injection and stretching as it is often associated with plantar fasciitis. It can take some time for your condition to improve following these treatments though, and I would usually have a patient trial conservative treatment for a minimum of 6 months prior to giving further consideration of surgery. If you have an MRI which is equivocal of your diagnosis, I think a guided-cortisone injection would be the next step in your management. Kind regards
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Orthopaedic Surgeon
I would recommend caution when it comes to shockwave therapy for nerve entrapments. This has traditionally been regarded as a contra-indication for the use of shockwave, and there is no strong evidence to support it in the treatment of a Baxter's nerve entrapment.
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