Heel Nerve Block: Targeted Treatment for Nerve-Related Heel Pain

Heel nerve block is an image-guided injection used in selected patients when heel pain appears to come from an irritated or entrapped nerve rather than only from the plantar fascia, Achilles tendon, heel fat pad, bone, joint, or skin.

This procedure may be discussed for nerve-related heel pain involving the medial calcaneal nerve, Baxter’s nerve, also called the inferior calcaneal nerve, or related branches of the tibial nerve near the inner ankle and heel.

At SpinePain Solutions, a heel nerve block is not treated as a generic injection for every sore heel. Heel pain has many possible causes. The goal is to determine whether a specific nerve pathway is carrying the pain signal and whether a targeted diagnostic or therapeutic injection makes sense.

Patients with nerve-related heel pain may describe burning, tingling, electric pain, buzzing, numbness, hypersensitivity, or pain that feels different from classic plantar fasciitis. Some patients have pain on the inner heel. Others have pain under the heel, pain radiating toward the arch, or tenderness near the medial calcaneal region.

A heel nerve block may be diagnostic, therapeutic, or both. If numbing the suspected nerve region temporarily improves the familiar heel pain, the response may help confirm that a nerve is involved. If inflammation, irritation, or mechanical sensitivity around the nerve decreases, relief may last longer than the numbing medicine itself.

Important: Heel Pain Is Not One Diagnosis

Heel pain can come from plantar fasciitis, heel fat pad atrophy, calcaneal stress fracture, Achilles tendon disease, bursitis, tarsal tunnel syndrome, Baxter’s nerve entrapment, medial calcaneal nerve irritation, peripheral neuropathy, inflammatory disease, vascular disease, infection, tumor, or referred pain from the spine.

A heel nerve block is most useful when the pain pattern, exam, imaging, ultrasound findings, or response to prior care suggests a nerve-related heel pain pathway.

Quick Answer: What Is a Heel Nerve Block?

It is an injection near a heel-related nerve. Common targets include the medial calcaneal nerve, Baxter’s nerve, or related tibial nerve branches.
It may help selected nerve-related heel pain. Symptoms may include burning, tingling, buzzing, electric pain, numbness, or hypersensitivity.
It is not the same as a plantar fascia injection. A plantar fascia injection targets the fascia. A heel nerve block targets a nerve pathway.
It can be diagnostic. Relief after numbing the nerve region may support that the nerve is part of the pain generator.
It can be therapeutic. Medication around the nerve may reduce irritation or sensitivity in selected patients.
Ultrasound guidance may improve precision. The heel contains nerves, vessels, fascia, fat pad, tendon, bone, and soft tissue that can overlap clinically.
It should not delay evaluation of red flags. Fracture, infection, vascular compromise, diabetic foot problems, or rapidly worsening symptoms need prompt care.

What Nerves Can Cause Heel Pain?

Several nerves can contribute to heel pain. The target depends on where the pain is felt, what triggers it, and what the examination suggests.

Medial Calcaneal Nerve

The medial calcaneal nerve usually branches from the tibial nerve and supplies sensation to the inner and bottom part of the heel. Irritation of this nerve may cause focal heel sensitivity, burning, tingling, numbness, or pain over the medial plantar heel region.

Baxter’s Nerve

Baxter’s nerve, also called the inferior calcaneal nerve or the first branch of the lateral plantar nerve, can become irritated or entrapped near the inner heel and plantar foot. Baxter’s nerve pain can overlap with plantar fasciitis and may be missed when every heel pain problem is placed in the plantar fascia basket.

Tibial Nerve and Tarsal Tunnel Branches

The tibial nerve travels behind the inner ankle through the tarsal tunnel and gives branches to the heel and foot. Tarsal tunnel syndrome or branch-level irritation may cause burning, numbness, tingling, or radiating foot pain.

S1 Nerve Root or Sciatic Pathway

Heel pain may occasionally be referred from the lumbar spine or sciatic nerve pathway. This is especially important when heel pain occurs with back pain, leg radiation, numbness, weakness, or symptoms above the ankle.

The Heel Has More Than a Fascia

Plantar fasciitis is common, but it is not the only heel pain diagnosis. When burning, buzzing, tingling, numbness, or focal nerve sensitivity appears, the nerve map deserves attention.

Symptoms That May Suggest Nerve-Related Heel Pain

Nerve-related heel pain often behaves differently from ordinary tissue soreness. It may feel sharp, burning, electric, buzzing, tingling, or hypersensitive.

Symptoms that may raise suspicion include:

Burning pain on the inner or bottom heel
Electric, buzzing, zapping, or tingling sensation
Heel pain that radiates toward the arch or plantar foot
Focal tenderness near the medial heel or nerve pathway
Pain worsened by standing, walking, or pressure over the nerve region
Pain that does not follow the classic plantar fasciitis pattern
Heel pain with normal or mild plantar fascia imaging findings
Persistent heel pain despite plantar fasciitis treatment
Heel sensitivity to touch, shoes, orthotics, or socks
Symptoms that overlap with tarsal tunnel syndrome

These features do not prove that a heel nerve block will help. They simply suggest that a nerve-related source should be considered.

Heel Nerve Block vs. Other Heel Pain Treatments

Heel pain treatments should match the diagnosis. A nerve block is not a replacement for plantar fascia care, stress fracture care, Achilles treatment, or diabetic foot evaluation when those are the true problem.

Condition	Common Clues	Possible Treatment Direction
Plantar Fasciitis	First-step morning pain, plantar fascia tenderness, pain after rest	Stretching, footwear, orthotics, therapy, plantar fascia injection or other fascia-directed care when appropriate
Heel Fat Pad Pain	Central heel pain, bruised feeling, worse on hard floors, reduced cushioning	Cushioning, heel cups, footwear modification, avoiding hard-surface overload
Calcaneal Stress Fracture	Bone pain, swelling, pain with weight-bearing, recent activity increase	Imaging, protected weight-bearing, orthopedic or podiatry care
Baxter’s Nerve Irritation	Medial plantar heel pain, burning or sharp pain, overlap with plantar fasciitis	Heel nerve block, ultrasound evaluation, nerve hydrodissection, therapy, surgery referral in selected cases
Medial Calcaneal Nerve Pain	Focal medial heel pain, burning, numbness, tenderness over calcaneal nerve region	Diagnostic nerve block, ultrasound-guided injection, hydrodissection in selected cases
Tarsal Tunnel Syndrome	Burning, numbness, tingling, radiating foot pain, symptoms near inner ankle or sole	Tarsal tunnel evaluation, EMG/NCS, ultrasound or MRI when needed, surgical referral in selected cases

Why Ultrasound Guidance Matters

Heel nerve targets can be small and variable. Ultrasound may help identify the tibial nerve region, calcaneal branches when visible, surrounding vessels, plantar fascia, heel fat pad, soft tissue lesions, and nearby tissue planes.

Ultrasound may help the physician:

Identify the suspected nerve region
Assess plantar fascia thickness or nearby soft tissue findings when relevant
Evaluate heel fat pad, masses, cysts, or fluid collections when visible
Identify nearby arteries and veins
Guide the needle toward the target region
Watch medication or fluid spread around the intended tissue plane
Avoid injecting directly into the nerve
Improve confidence that the diagnostic response is meaningful

The Target Is Small, the Diagnosis Is Not

A heel nerve block should not be a blind poke into a painful heel. The goal is to match the pain map to a nerve target and use imaging when precision matters.

What Happens During a Heel Nerve Block?

A heel nerve block is usually performed as an outpatient procedure. The exact technique depends on the suspected nerve, pain location, ultrasound findings, medication choice, and treatment goal.

Step 1: Evaluation and Target Selection

The physician reviews the location of heel pain, triggers, footwear, prior plantar fasciitis treatments, imaging, exam findings, numbness, tingling, diabetes history, prior surgery, trauma, and possible spine-related symptoms.

Step 2: Ultrasound Mapping

Ultrasound may be used to evaluate the nerve region, plantar fascia, heel fat pad, vessels, soft tissue planes, and safest needle path.

Step 3: Needle Placement

A small needle is guided toward the suspected nerve region. The goal is to place medication near the nerve pathway, not inside the nerve itself.

Step 4: Medication Injection or Hydrodissection

Medication or fluid is placed around the nerve region. In selected cases, hydrodissection may be used to gently separate a nerve from tight fascia, scar tissue, or irritated tissue planes.

Step 5: Response and Follow-Up

The patient should track heel pain, burning, numbness, standing tolerance, walking tolerance, shoe tolerance, first-step pain, and whether the familiar symptoms improve while the nerve region is numbed.

Track the Exact Heel Symptom

After the block, patients should notice whether the burning, buzzing, inner heel pain, plantar heel pain, shoe sensitivity, or walking-triggered pain changes. That detail helps interpret the result.

What Medication or Fluid Is Used?

The injectate depends on the suspected diagnosis, nerve target, ultrasound findings, medical history, and treatment goal.

Local Anesthetic

Local anesthetic may temporarily numb the nerve region and provide diagnostic information. If the familiar heel pain improves during the anesthetic window, the response may support that the targeted nerve is part of the pain pathway.

Saline

Saline may be used as a mechanical fluid to separate tissue planes around a nerve. It does not have a specific regenerative effect, but it may help open space around an irritated nerve region.

D5W

D5W, or 5% dextrose in water, is sometimes discussed in peripheral nerve hydrodissection. It may be considered selectively, but it should not be presented as a guaranteed cure for heel nerve pain.

Corticosteroid

Steroid may reduce inflammation around an irritated nerve or nearby soft tissue in selected cases. It should be used cautiously, especially near superficial tissues, fat pad, skin, tendons, and nerves. Repeated steroid exposure can have tissue consequences.

PRP or Biologic Options

PRP or biologic options may be discussed in selected cases, especially when plantar fascia or soft tissue pathology overlaps with nerve irritation. Coverage varies, evidence depends on the target, and these options should not delay evaluation of fracture, infection, vascular disease, or severe nerve compression.

The Fluid Is Not the Whole Story

A heel nerve block works best when the correct nerve is targeted. The injectate matters, but the map matters first.

When a Heel Nerve Block May Help

A heel nerve block may be reasonable when symptoms suggest a nerve-related heel pain pattern and conservative or fascia-directed treatment has not provided enough relief.

Patients Who May Be Better Candidates

Patients with burning, tingling, buzzing, or electric heel pain
Patients with focal medial heel sensitivity
Patients with pain radiating toward the arch or plantar foot
Patients with persistent heel pain despite plantar fasciitis treatment
Patients with heel pain that does not follow the classic plantar fasciitis pattern
Patients with suspected Baxter’s nerve irritation
Patients with suspected medial calcaneal nerve irritation
Patients with possible tarsal tunnel branch irritation
Patients with post-surgical or post-traumatic heel nerve sensitivity
Patients who need diagnostic clarification before more advanced treatment

When a Heel Nerve Block May Not Help

A heel nerve block may not help when the pain is coming from a non-nerve structure or when a different diagnosis needs attention first.

Heel Nerve Block May Be Less Useful When There Is:

Classic plantar fasciitis without nerve features
Calcaneal stress fracture or bone injury
Heel fat pad atrophy or bruising as the main problem
Achilles tendon disease or retrocalcaneal bursitis
Infection, wound, ulcer, or diabetic foot complication
Inflammatory arthritis or systemic disease driving the pain
Peripheral neuropathy affecting both feet diffusely
Lumbar radiculopathy or spine-related referred pain
Vascular insufficiency
Widespread foot pain without a clear nerve target

Do Not Ignore Heel Pain Red Flags

Severe pain after trauma, fall, or suspected fracture
Inability to bear weight
Marked swelling, redness, warmth, fever, or drainage
Open wound, ulcer, or infection concern
Diabetes with new wound, infection, or rapidly worsening foot pain
Sudden cold, blue, pale, or pulseless foot
New progressive weakness, foot drop, or rapidly worsening numbness
History of cancer with new unexplained heel or bone pain

Baxter’s Nerve Pain

Baxter’s nerve, also called the inferior calcaneal nerve, is a small branch that may become irritated or compressed near the inner heel and plantar foot. It can be overlooked because the symptoms often overlap with plantar fasciitis.

Possible clues include:

Medial plantar heel pain
Burning or sharp pain near the inner heel
Pain worsened by standing, walking, or foot mechanics
Heel pain that persists despite plantar fasciitis care
Tenderness near the abductor hallucis region or medial heel
Possible imaging signs of abductor digiti minimi muscle changes in chronic cases

A Baxter’s nerve block may help clarify whether this nerve is involved. However, Baxter’s nerve pain can coexist with plantar fasciitis, heel spurs, foot biomechanics, or tarsal tunnel-related irritation, so the diagnosis should not be made from one clue alone.

Medial Calcaneal Nerve Pain

The medial calcaneal nerve supplies sensation to the heel skin and fat pad region. Irritation may cause focal heel pain, numbness, burning, or tenderness over the inner or plantar heel.

Possible clues include:

Focal medial heel pain
Burning, tingling, or numbness over the heel pad region
Pain with direct pressure over the inner heel
Scar-related heel pain after surgery or trauma
Symptoms that do not radiate far into the toes
Positive local tenderness or Tinel-type sensitivity over the calcaneal nerve region

A medial calcaneal nerve block may help determine whether this small sensory nerve is contributing to the heel pain.

Tarsal Tunnel and Heel Nerve Pain Overlap

The tibial nerve and its branches travel through the inner ankle and foot. Tarsal tunnel syndrome may cause burning, numbness, tingling, or radiating pain into the sole of the foot. In some patients, heel branches may be involved.

Tarsal tunnel should be considered when symptoms include:

Burning or tingling in the sole of the foot
Symptoms radiating from the inner ankle into the arch or toes
Night symptoms or nerve-like pain in the foot
Symptoms worsened by prolonged standing or walking
History of ankle trauma, swelling, ganglion cyst, varicosities, flatfoot, diabetes, or inflammatory disease

In these cases, a small heel nerve block may not be enough. Evaluation may require ultrasound, MRI, EMG/NCS, foot and ankle evaluation, or surgical discussion depending on severity.

What If the Heel Nerve Block Helps?

If a heel nerve block helps, the response may support that the targeted nerve is a meaningful pain generator. The next step depends on how much relief occurred, how long it lasted, and whether the patient’s walking, standing, and shoe tolerance improved.

Possible next steps may include:

Continued footwear and orthotic changes
Physical therapy, nerve gliding, calf stretching, or foot mechanics work
Activity modification while symptoms calm down
Repeat block in selected cases when the first response was meaningful
Nerve hydrodissection if scar, fascia, or tissue tethering is suspected
Plantar fascia treatment if fascia pathology also contributes
Foot and ankle or podiatry referral if structural disease remains important
Tarsal tunnel or surgical evaluation if symptoms suggest severe entrapment
Peripheral nerve stimulation in rare chronic focal nerve pain cases after careful diagnosis

Relief Gives Direction

A helpful heel nerve block can identify the nerve pathway, but the next step should also address pressure, footwear, mechanics, fascia, and activity triggers when they contribute.

What If the Heel Nerve Block Does Not Help?

If the block does not help, the information can still be valuable. It may mean the wrong nerve was targeted, the heel pain is not nerve-mediated, or another diagnosis is more important.

When the block does not help, the plan may shift toward:

Rechecking the exact pain location
Reviewing ultrasound findings
Considering plantar fasciitis or plantar fascia tear
Considering heel fat pad atrophy or fat pad bruising
Considering calcaneal stress fracture or bone lesion
Considering Achilles, bursitis, or posterior heel causes
Considering tarsal tunnel syndrome, peripheral neuropathy, or lumbar radiculopathy
Considering MRI, X-ray, EMG/NCS, vascular testing, podiatry, orthopedic, or foot and ankle evaluation when appropriate
Avoiding repeated injections without diagnostic clarity

A Negative Block Is Still Information

If the familiar heel pain does not improve after a carefully selected nerve block, the diagnosis should be reconsidered before repeating the same procedure.

Risks and Side Effects

Heel nerve block is generally a low-risk outpatient procedure when performed carefully, but it is still a medical procedure near small nerves, blood vessels, fascia, heel fat pad, and soft tissue.

Possible Risks and Side Effects Include:

Temporary soreness at the injection site
Bruising or bleeding
Temporary numbness, tingling, warmth, or altered sensation
Temporary increase in heel pain
Infection, uncommon but possible
Nerve irritation or nerve injury, uncommon but important
Intraneural injection if the needle enters the nerve, uncommon but important
Vascular puncture or hematoma
Allergic reaction to medication, uncommon but possible
Local anesthetic side effects
Skin color change or fat pad change if steroid is used
Blood sugar elevation in some diabetic patients if steroid is used
Persistent numbness or altered heel sensation
Failure to improve

Patients taking blood thinners or patients with bleeding disorders, diabetes, neuropathy, infection risk, ulcers, vascular disease, medication allergies, prior heel surgery, or rapidly worsening symptoms should discuss risks carefully before the procedure.

Recovery After a Heel Nerve Block

Most patients go home the same day. Some patients notice temporary numbness or relief if local anesthetic is used. Others may feel soreness or a brief flare after the procedure.

General Recovery Tips

Track pain relief during the first few hours after the block.
Notice whether burning, tingling, numbness, or medial heel pain improves.
Notice whether standing and walking tolerance improves.
Avoid aggressive walking, running, or prolonged standing immediately after the procedure.
Do not overuse the foot simply because pain is temporarily reduced.
Use supportive shoes, heel cushioning, orthotics, or pads as instructed.
Call the office if symptoms are severe, worsening, or unusual.

If the block is diagnostic, the early response is especially important. Patients should write down what improved, how much relief occurred, and how long relief lasted.

Cost, Insurance, and Coverage

Insurance coverage for heel nerve block depends on the diagnosis, payer policy, documentation, medical necessity, ultrasound guidance, medication used, and whether prior authorization is required.

Coverage may vary because heel nerve pain can be coded and documented differently depending on whether the suspected source is medial calcaneal nerve irritation, Baxter’s nerve entrapment, tarsal tunnel branch irritation, post-surgical nerve pain, or another diagnosis.

Patients should ask:

Is heel nerve block covered by my insurance?
Is ultrasound guidance covered?
Which nerve is being targeted?
Is this a medial calcaneal nerve block, Baxter’s nerve block, tibial branch block, or another target?
Is this diagnostic, therapeutic, or both?
What medication or fluid will be used?
Could plantar fascia, stress fracture, fat pad, or tarsal tunnel be the real issue?
What are my out-of-pocket costs?
What happens if the block helps?
What happens if it does not help?

For treatments that are not covered or are self-pay, our office can discuss payment options. For eligible patients, CareCredit financing may be available depending on approval and available terms.

Questions to Ask Before a Heel Nerve Block

Before a heel nerve block, patients should understand which nerve is being targeted and why.

Helpful Questions Include:

Do my symptoms sound nerve-related?
Which nerve do you think is involved?
Could this be plantar fasciitis, stress fracture, heel fat pad pain, Achilles disease, or tarsal tunnel syndrome instead?
Will ultrasound guidance be used?
Can the plantar fascia, heel fat pad, and nearby soft tissues be evaluated?
Is this a diagnostic block, treatment injection, hydrodissection, or combination?
What medication or fluid will be used?
How much relief would count as meaningful?
How long should relief last?
What should I track after the block?
What are the risks for my specific situation?
What are the next steps if the block helps?
What are the next steps if it does not help?

The Best Question Before the Block

Ask: “Are we treating heel nerve pain, plantar fascia pain, bone pain, fat pad pain, or tarsal tunnel pain?” The answer decides whether the block belongs in the plan.

Heel nerve block is part of a broader nerve pain and foot pain care map. Patients with overlapping foot, ankle, leg, spine, or nerve symptoms may also benefit from related topics.

Frequently Asked Questions About Heel Nerve Block

What is a heel nerve block?

A heel nerve block is an injection placed near a nerve pathway that may be causing heel pain. Common targets include the medial calcaneal nerve, Baxter’s nerve, or related branches of the tibial nerve.

What is a calcaneal nerve block?

A calcaneal nerve block usually refers to an injection near one of the sensory nerves that supplies the heel, such as the medial calcaneal nerve. It may be used diagnostically or therapeutically in selected nerve-related heel pain.

What is Baxter’s nerve?

Baxter’s nerve, also called the inferior calcaneal nerve, is a small nerve branch near the inner heel and plantar foot. Irritation or entrapment can cause medial plantar heel pain that may mimic plantar fasciitis.

Is heel nerve pain the same as plantar fasciitis?

No. Plantar fasciitis involves the plantar fascia. Heel nerve pain involves irritation or entrapment of a nerve. The symptoms can overlap, and some patients may have both.

What does nerve-related heel pain feel like?

Nerve-related heel pain may feel burning, tingling, electric, buzzing, numb, sharp, hypersensitive, or radiating toward the arch or sole.

When is a heel nerve block considered?

It may be considered when the pain pattern, examination, ultrasound findings, imaging, or prior treatment response suggests medial calcaneal nerve irritation, Baxter’s nerve irritation, tarsal tunnel branch irritation, or post-surgical nerve pain.

Is ultrasound guidance used?

Ultrasound guidance may be used to identify the suspected nerve region, nearby vessels, plantar fascia, heel fat pad, and soft tissue planes. It can help guide the needle and medication more precisely.

Is this the same as a plantar fascia injection?

No. A plantar fascia injection targets the fascia. A heel nerve block targets a nerve pathway. The correct treatment depends on the diagnosis.

Can a heel nerve block diagnose Baxter’s nerve pain?

It can help. If numbing the suspected Baxter’s nerve region improves the familiar heel pain, the response may support that Baxter’s nerve is involved.

Can a heel nerve block diagnose medial calcaneal nerve pain?

Yes. If numbing the medial calcaneal nerve region improves focal heel pain, burning, numbness, or tenderness, it may support medial calcaneal nerve involvement.

Does a heel nerve block cure heel pain?

Not always. Some patients improve significantly, some have temporary relief, and some do not improve if the heel pain is coming from another source.

What medication is injected?

The injectate may include local anesthetic, saline, D5W, corticosteroid, or another option depending on the suspected diagnosis, treatment goal, and physician judgment.

What is heel nerve hydrodissection?

Heel nerve hydrodissection uses fluid under ultrasound guidance to separate an irritated nerve from tight fascia, scar tissue, or crowded tissue planes. It may be considered in selected cases.

What if the block does not help?

If the block does not help, the diagnosis may need to be reconsidered. Other causes include plantar fasciitis, heel fat pad pain, stress fracture, Achilles disease, tarsal tunnel syndrome, peripheral neuropathy, vascular disease, or spine-related pain.

What are the risks?

Risks may include soreness, bruising, bleeding, infection, temporary numbness, pain flare, nerve irritation, nerve injury, vascular puncture, allergic reaction, local anesthetic side effects, steroid-related skin or fat pad changes, blood sugar elevation if steroid is used, persistent altered heel sensation, and failure to improve.

How long does relief last?

Relief varies. Some patients improve only during the numbing window. Others may improve for days, weeks, or longer if nerve irritation decreases.

Can the block be repeated?

It may be repeated in selected cases when the first block provides meaningful relief and the diagnosis supports repeating treatment. Repeated injections should not continue indefinitely without reassessing the diagnosis.

Is heel nerve block covered by insurance?

Coverage depends on the diagnosis, payer policy, documentation, medical necessity, ultrasound guidance, medication used, and whether prior authorization is required.

Key Takeaways

Heel nerve block targets selected nerve-related heel pain, not every heel pain diagnosis.
Common nerve targets include the medial calcaneal nerve, Baxter’s nerve, and related tibial nerve branches.
Symptoms may include burning, tingling, buzzing, electric pain, numbness, or focal medial heel sensitivity.
Heel nerve pain can mimic plantar fasciitis, and both can occur together.
Ultrasound guidance may improve precision by helping identify nerves, vessels, fascia, heel fat pad, and medication spread.
A diagnostic block can help confirm whether the targeted nerve is part of the pain pathway.
No relief after a careful block should prompt reassessment before repeating the same treatment.
Red flags such as trauma, infection, diabetic foot wound, vascular symptoms, inability to bear weight, or rapidly worsening symptoms need prompt evaluation.
Further treatment may include footwear changes, therapy, hydrodissection, plantar fascia care, tarsal tunnel evaluation, foot and ankle referral, or neuromodulation in rare chronic focal cases.
The goal is to identify the true heel pain generator and treat the correct structure.

Burning, Buzzing, or Nerve-Like Heel Pain?

Heel pain is often blamed on plantar fasciitis, but nerves can also cause stubborn heel pain. The key is separating fascia pain, fat pad pain, bone pain, and nerve pain.

At SpinePain Solutions, we evaluate the pain pattern, exam findings, ultrasound findings, footwear triggers, prior treatments, and nerve pathway before deciding whether heel nerve block, hydrodissection, plantar fascia care, or another treatment makes sense.

Schedule a Consultation

This article is intended for educational purposes only and should not replace individualized medical advice. Heel pain, plantar fasciitis, Baxter’s nerve entrapment, medial calcaneal nerve pain, tarsal tunnel syndrome, heel fat pad pain, calcaneal stress fracture, Achilles tendon disease, peripheral neuropathy, vascular disease, infection, diabetic foot problems, and spine-related nerve pain can have multiple causes. New, severe, traumatic, infected, swollen, cold, blue, weak, numb, diabetic foot-related, vascular, or rapidly worsening symptoms should be evaluated promptly. Treatment decisions should be based on a complete history, physical examination, ultrasound or imaging findings when appropriate, nerve testing when appropriate, diagnosis, risks, benefits, alternatives, and a discussion with your physician.