Those with disorders of the hand, wrist, foot and ankle can get answers to their problems.
Orthotics, Arch Supports, and Orthoses
About our podiatrist: Tae Kim, DPM
Carpal tunnel syndrome is the result of pinching of the median nerve in the palm. It causes nerve symptoms such as numbness and tingling, as well as hand pain. It can refer pain up the arm. The diagnosis is made by the physician taking a careful history and physical exam, and can be confimed with a nerve conduction study. Treatments include wrist splint, anti-inflammatory medications, therapy, acupuncture, injections, and surgery. 
Tendinitis of the finger flexor can create pain and swelling in the palm. If this becomes long-standing, the finger may lock when bent, making it hard to open. This condition is known as a trigger finger. It can be treated with rest, anti-inflammatory medication, splint, steroid injection, and surgery.
Pain in the arch of the foot can be due to a condition known as plantar fasciitis (often known as a heel spur). This often hurts worst in the mornings, gets slightly better, and then hurts again with prolonged walking. It is due to inflammation of and poor blood flow to the plantar fascia, a thick tissue that supports the arch. Treatment may include anti-inflammatory medication, arch supports, and physical therapy.
A bunion forms when the joint at the base of the big toe moves out of place. This forces the toe to bend inward, creating a painful bump of bone. The joint can become stiff, red and inflammed, leading to difficulty wearing shoes.
Bunions develop when the normal balance of forces at the joint is disrupted, leading to instability and deformity. They are usually caused by the way a person walks, faulty foot development, heredity, and shoeware. While bunions themselves are not genetic, the predisposition to developing them is. People with flat feet are also prone to getting bunions. There is a higher prevalence among women, explained by their tendency to wear narrow-toed shoes.
Home remedies include wearing a nonmedicated bunion pad available at many drug stores; using shoes with wide, deep toe boxes; applying ice several times a day to inflammed bunions; and keeping shoe heels to under 2 inches.
A podiatrist may be able treat the bunion conservatively. Treatment varies depending on the type and severity of the bunion. Bunions are generally easier to treat if a podiatrist intervenes early; nonsurgical options become less effective as the bunion gets larger and more painful. The first goal of treatment is to alleviate pressure on the bunion and stop deformity. This may involve padding, taping, anti-inflammatory medications, steroid injections, physical therapy, and orthoses (shoe inserts).
When conservative measures fail, several procedures are available. The podiatrist may remove the bony enlargement and restore the normal toe alignment through a bunionectomy.
Hammertoe deformities occur when there is an imbalance between tendons to the toes, leading to contracture of the toes. As the toe joints become bent, the shoe box may put pressure on them, causing pain and eventually calluses. A podiatrist can surgically realign these joints or recommend proper shoeware.
A benign but painful enlargement of nerve may occur between the toes, called a neuroma. This usually develops between the third and fourth toes, and may be a result of trauma, arthritis, high-heeled shoes, or abnormal bone structure. Symptoms include burning, tingling or numbness in the toes. A podiatrist can surgically correct the neuroma.
Orthotics, Arch Supports, and Orthoses
People often interchange the terms "orthotics" and "arch supports." Podiatrists can custom-make shoe inserts which are designed to improve foot function and minimize deformity and pain. These inserts are called "orthoses" (pleural) or an "orthosis" (singular). "Orthotic" is technically not a noun; it's an adjective, as in "orthotic device." One type of orthosis is the arch support, but podiatrists use many other types of orthoses for other functions. Rigid orthoses control function and are made of a firm material. These may be used to correct leg-length difference, improve fallen arches, or put the ankle joints into a proper position. Soft orthoses are used to absorb shock, increase balance, and remove pressure from sore spots.
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| Dr. Kim is a board-certified podiatrist, a field that specializes in disorders of the foot and ankle.
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He received his podiatric degree from California College of Podiatric Medicine in San Francisco in 1998, and prior to this he attended UCLA and New York University. Dr. Kim is a 1st-degree black belt, and is fluent in Korean. He has an interest in care of diabetic feet, and performs many procedures in the office. He is available Tuesday mornings for consultation. Contact The Marlowe Institute to schedule an appointment.