Understanding Baxter Disease

Introduction & Definition of Baxter Disease

Baxter disease, also known as accessory navicular syndrome, is a condition that affects the foot and ankle area. It is a musculoskeletal disorder that involves an accessory bone called the navicular bone, which is located on the inside of the foot, near the arch. This condition occurs when the accessory navicular bone becomes inflamed, leading to pain and discomfort in the foot and ankle region.

Causes of Baxter Disease

The exact cause of Baxter disease is not fully understood, but it is believed to be related to overuse or repetitive strain on the foot. Individuals who engage in activities that involve excessive stress on the foot, such as running or jumping, are more prone to developing this condition. Additionally, genetics may play a role, as some people may have a naturally larger or more prominent accessory navicular bone.

Signs and Symptoms of Baxter Disease

Baxter disease typically presents with:

• Pain: The primary symptom of Baxter disease is pain, which can range from mild discomfort to sharp and intense pain. Pain may worsen during physical activities or after prolonged periods of standing
• Tenderness: The area around the accessory navicular bone (on the inside of the foot, near the arch) may be tender to the touch.
• Swelling: Swelling may be present, indicating inflammation in the foot.
• Redness: The affected area might appear reddish due to increased blood flow and inflammation.
• Limited Mobility: Pain and discomfort can lead to a decreased range of motion in the foot.

Diagnosis of Baxter disease

Diagnosing Baxter disease involves a combination of clinical evaluation, imaging studies, and patient history assessment. A healthcare professional will perform a physical examination to assess the location of pain and tenderness. X-rays may be ordered to visualize the accessory navicular bone and rule out other conditions such as fractures.

During the physical examination, the doctor will press on different areas of the foot to identify the source of pain and tenderness. They may also assess the patient’s gait and foot mechanics to understand how the condition may be affecting their movement.

One common special test used for Baxter disease is the “medial palpation test.” This involves pressing down on the accessory navicular bone to check for tenderness and reproduce the patient’s symptoms. Additionally, the doctor may perform stress tests to evaluate the stability of the foot’s arch.

Medical Treatment

The initial treatment for Baxter disease focuses on pain management and reducing inflammation. This may include:

• Rest: Giving the foot time to heal by avoiding activities that exacerbate the pain.
• Ice: Applying ice to the affected area can help reduce inflammation and provide relief.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to alleviate pain and swelling.

Physiotherapy Treatment

Physiotherapy plays a crucial role in the recovery process for Baxter disease. A physiotherapist can design a personalized exercise program to improve foot strength, flexibility, and stability, ultimately helping patients alleviate pain, enhance mobility, and regain their quality of life. This may involve:

1. Customized Treatment Plan

Based on the assessment findings, the physiotherapist designs a personalized treatment plan tailored to the patient’s specific needs and goals. This plan takes into account the severity of the condition, the patient’s physical capabilities, and their desired level of activity.

2. Stretching Exercises

Stretching exercises are an integral part of the physiotherapy treatment plan for Baxter disease. These exercises target the muscles, tendons, and ligaments in the foot and ankle, aiming to improve flexibility and reduce muscle tension. Stretching can also help alleviate discomfort and promote proper foot mechanics.

Example Stretching Exercises:

1. Plantar Fascia Stretch: Gently pull the toes back towards the shin, holding the stretch for 15-20 seconds. Repeat multiple times on both feet.
2. Calf Stretch: Place one foot forward and one foot back, keeping both heels on the ground. Lean forward, feeling a stretch in the calf muscles. Hold for 20-30 seconds on each side.

3. Strengthening Exercises

Strengthening exercises are essential for enhancing the stability of the foot’s arch and supporting the accessory navicular bone. These exercises target the intrinsic and extrinsic muscles of the foot, as well as the muscles of the lower leg. Strong muscles can help improve foot alignment and reduce strain on the inflamed area.

Example Strengthening Exercises:

1. Toe Raises: Stand on one foot and lift the other foot’s heel off the ground, rising onto the toes. Lower back down slowly. Perform 10-15 repetitions on each foot.
2. Ankle Resistance Band Exercises: Attach a resistance band to a sturdy object and loop it around the foot. Perform exercises like ankle dorsiflexion and inversion against the resistance of the band.

4. Balance and Proprioception Training

Baxter disease can disrupt the body’s sense of balance and proprioception (awareness of body position in space). Balance training involves practicing exercises that challenge stability, helping the foot adapt to uneven surfaces and movements. Proprioception training aims to improve the brain’s connection to the foot’s movements and positions.

Example Balance and Proprioception Exercises:

1. Single Leg Stance: Stand on one foot, holding the position for 20-30 seconds. Progress to closing your eyes for an added challenge.
2. Bosu Ball Exercises: Perform exercises on a Bosu ball to challenge balance and proprioception.

5. Orthotic Prescription

In some cases, the physiotherapist may recommend custom orthotic inserts to provide additional support to the foot’s arch. These inserts are designed to distribute pressure evenly, promote proper alignment, and reduce strain on the accessory navicular bone.

6. Elite Treatment

In addition to all the above treatments Physiotherapist at Elite Physiotherapy and sports injury centre uses some highly advanced and researched based modalities such as Shock wave therapy, TRF therapy, High-intensity class 4 laser, Manual therapy, Mechanical therapy, etc.

Conclusion

Physiotherapy treatment for Baxter disease is a comprehensive and multifaceted approach that addresses the underlying causes of the condition. Through a combination of stretching, strengthening, balance training, and orthotic support, individuals with Baxter disease can experience significant pain relief, improved foot function, and enhanced overall quality of life. It’s important to work closely with a skilled physiotherapist to ensure a tailored and effective treatment plan that meets individual needs.

FAQs

Is Baxter disease a common condition?

Baxter disease is relatively uncommon but can occur in individuals who engage in activities that stress the foot.

Can Baxter disease affect both feet?

Yes, Baxter disease can affect one or both feet, though it often occurs in one foot.

Are there surgical treatment options for Baxter disease?

In some cases, surgical intervention may be considered if conservative treatments do not provide relief.

Can physiotherapy completely cure Baxter disease?

Physiotherapy can greatly improve the symptoms and function of the foot, but a complete cure may vary from person to person.

How long does recovery take with physiotherapy?

Recovery time varies, but with consistent physiotherapy and proper care, most individuals can experience significant improvement within a few months.