I have a problem in my bilateral medial arch with pain and swelling. it is slightly better with pt treatment. is it tibial tendonitis and what should i do?

ARCH SUPPORT!: There are many possibe reasons that you may have pain in the arch, but try arch supports like spenco polysorb (http://www.Spenco.Com/products/footcare/poly-sorb) and otc anti-inflammatories (like aleve). If these don't help, see a podiatrist for more biomechanical control and maybe a prescription anti-inflammatory.

Arch pain: It may be posterior tibial tendinitis or plantar fasciitis. A sonogram or MRI is indicated. See a podiatrist.

Sounds like a : Good biomechanical exam would help. Depending in the outcome sounds like orthotic therapy may be beneficial to you.

I would start: With wearing an orthotic or arch support to support the arch and the ligamentous and tendons that hold it up. Plantar fascitiis and or posterior tibial tendonitis or dysfucntion are the possible diagnosis without being able to physically examine you.