For some, the use of supportive shoes alone is not sufficient to provide the necessary support. Over the counter inserts and custom orthotics can be greatly helpful in providing support. However, custom orthotics can be rather expensive. Thus, trying a firm/rigid (not gels or cushion) insert can be a good first option. It is important to note that an insert is not a substitute for supportive shoes and should be worn together. Tarsal Tunnel Syndrome - This affliction is related to carpal tunnel syndrome of the wrist but in this scenario it is the tibial nerve that gets pinched triggering inflammation and ache. It proved rich pickings. The prospector had touched just the tip of a dyke that cut clear through the small mountain, containing hundreds of tons of payable ore. The whole eminence was soon pegged out by hopeful diggers trying every colour of rock they might see, but the payable ore seemed to be all within the one peg, the Prospectors Claim named the Zelma. Eddie pretended outrage. "Damn typical Slikker. What's happened to the younger generation these days? Put a roof over their heads, food in their mouths, then at the first sign of trouble - whoosh! They're off. Flaky! That's the word. Loose and flaky the lot." Excess rolling of the foot, or hyperpronation results in the extra application of strain on the tendon. This is because people who hyperpronate have their arches drop from the non-weight bearing position or sitting position, to the weight bearing or standing position. When the arches drop, the ankles roll in and the heels lean in. Leaning in of the heels results in increased tension on the inner attachment of the tendon. This results in pain. While I was at the podiatrist for the cortisone injection, she likewise recommended some physical treatment that included ultrasound treatment, deep tissue massage, and electro stimulation (electrostim) therapy. The diagnosis of plantar fasciitis is usually made by clinical examination alone. 4 5 The clinical examination may include checking the patient’s feet and watching the patient stand and walk. The clinical examination will take under consideration a patient's medical history, physical activity, foot pain symptoms and more. The doctor may decide to use imaging studies like radiographs (X-rays), diagnostic ultrasound and MRI An orthotic arch support, specially molded to fit your foot, may be part of your treatment. These supports can be particularly helpful if you have flat feet or high arches. You can tell if that is what is needed when short-term taping decreases your heel pain. Non-steroidal anti-inflammatory drugs ( NSAIDs ) - medications with analgesic (pain reducing), antipyretic (fever reducing) effects. In higher doses they also have anti-inflammatory effects - they reduce inflammation (swelling). Non-steroidal distinguishes NSAIDs from other drugs which contain steroids, which are also anti-inflammatory. NSAIDs are non-narcotic (they do not induce stupor). For patients with plantar fasciitis they may help with pain and inflammation. Footwear - proper-fitting shoes that provide good support are crucial. Athletes should be particularly fussy about the shoes they use when practicing or competing - sports shoes need to be replaced at specific intervals (ask your trainer).