All Posts Tagged: platelet rich plasma

shoulder pain orlando hand surgery

Shoulder Pain: Nonsurgical and Surgical Solutions

The shoulder is compromised of several joints that work together to provide us with a wide range of motion. Because we use our shoulders to perform a variety of different tasks throughout the day, it can be prone to injury and pain.

Treatment options for shoulder pain will vary depending on the severity of the injury or condition. Below, we have listed some of the most common causes of shoulder pain along with common treatment options. As with any condition or injury, it’s best to consult a doctor in order to receive a proper evaluation and treatment plan.

Common Causes of Shoulder Pain:

  • Shoulder Impingement Syndrome: 
    shoulder pain - dr. jason pirozzolo - shoulder bursitis

    Dr. Jason Pirozzolo explains shoulder bursitis.

    Shoulder impingement syndrome is a collection of shoulder symptoms related to impingement, bursitis, and tendinitis in and around the shoulder joint. The most common symptom of shoulder impingement is pain, especially when one tries to use the affected arm above the level of the head (e.g., overhead activity, throwing).

  • Arthritis:
    Arthritis in the shoulder usually results in swelling, pain and stiffness. Osteoarthritis is the most common type of arthritis in the shoulder. Pain due to osteoarthritis may worsen over time.
  • Instability:
    Instability occurs when the head of the upper arm bone is forced out of the shoulder socket. Instability is usually the result of an injury or overuse. Sometimes instability, or a dislocation, can occur repeatedly which can increase the risk of arthritis developing in the shoulder.
  • Fracture:
    A fracture, also known as a broken bone, often occurs as the result of a traumatic injury. Shoulder fractures in older patients can occur after a fall. Shoulder fractures are also common in high-energy contact sports.

Common Treatment Options for Shoulder Pain:

  • Activity Modification:
    Activity modification is suggested at the onset of symptoms when shoulder pain is mild. Rest and physical therapy may be recommended to improve pain. Your doctor may also prescribe medication such as nonsteroidal anti-inflammatory medications (NSAIDs) or corticosteroids.
  • Regenerative Medicine: 
    platelet rich plasma therapy for shoulder pain

    One patient shares his experience with using PRP therapy for shoulder pain.

    Regenerative Medicine procedures, such as platelet rich plasma (PRP) therapy injections and stem cell therapy injections, are available as an alternative to surgery. PRP therapy and stem cell therapy are powerful procedures that use your own body for healing. Learn more here.

  • Surgery:
    Surgery may be required to resolve some severe injuries and conditions of the shoulder. The type of surgery needed is dependent on the condition or injury. Some surgical options include: total shoulder surgery, reverse total shoulder surgery, shoulder arthroscopy, and open rotator cuff repair.

To discuss shoulder pain, or other upper extremity conditions and injuries with one of our doctors, call our office at (407) 841-2100 or request an appointment here.

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prp for wrist osteoarthritis

Regenerative Platelet Rich Plasma Injections for Wrist Osteoarthritis

Orlando, Florida – Wrist osteoarthritis is a “wear and tear” degeneration of the joint surfaces in your wrist. The wrist contains 8 carpal bones that serve as a junction between the other bones of your thumb, hand and forearm. Inflammation can occur at any of these joint surfaces, causing pain and decreased range of motion. Your doctor can make the diagnosis of wrist osteoarthritis by your history, physical examination, and x-rays.

Wrist osteoarthritis can range from mildly irritating to severely debilitating. Gordie Howe, a.k.a. “Mister Hockey,” had to retire from the game because of severe arthritis in his left wrist. Howe is widely regarded as one of the greatest hockey players of all time, but wrist osteoarthritis prematurely ended his career in the National Hockey League.

The mainstays of wrist osteoarthritis treatment are activity modification, immobilization, and specific physical therapy exercises. In essence, the goal is to stop the activities that led to the arthritis, perhaps by immobilizing or bracing the wrist with a splint for time, and then performing selective exercises to increase strength, stability, and range of motion. People with moderate or severe wrist osteoarthritis may require steroid injections such as cortisone into the wrist to reduce inflammation. If surgery is necessary, an orthopedic surgeon may perform a proximal row carpectomy, which is a procedure to remove several carpal bones in the wrist. Another more limiting option is a fusion, where the bones of the wrist are fused together so they cannot move relative to one another.

A newer, non-surgical option for wrist osteoarthritis is the use of platelet rich plasma (PRP). Unlike most medications, platelet rich plasma is produced from a patient’s own blood. “A small amount of blood is drawn and spun down to isolate a portion of the blood that contains platelets, growth factors, and other molecules that help facilitate healing,” reports Dr. Jason Pirozzolo, a sports medicine physician in Orlando, Florida and President of the American Regenerative Medicine Society.  “These are the same substances that are circulating in your blood normally; however, the PRP procedure concentrates the substances so they can be reinjected into the arthritic wrist.”

People with wrist osteoarthritis at the base of the thumb benefited from platelet rich plasma (PRP) injections in clinical studies. PRP treated individuals had less pain, greater strength, and greater wrist function than those treated with a placebo injection.1 Furthermore, platelet rich plasma improved outcomes in people with osteoarthritis in the carpal bones of the wrist.2

Wrist osteoarthritis is a chronic, painful, degenerative arthritis that limits range of motion and interferes with work and daily activities. In athletes, wrist osteoarthritis has been career-ending. As with other forms of osteoarthritis, treatment usually starts conservatively, with wrist splints, activity modification, and physical therapy. Physicians may use occasional steroid injections to reduce pain and inflammation. Severe cases of wrist osteoarthritis may require orthopedic surgical treatment. “Fortunately, platelet rich plasma therapy may prove to be an additional treatment tool in the physician’s toolbox. While additional research is needed, PRP may be able to help patients delay or avoid invasive treatments such as surgery,” said Pirozzolo.

 

Authored by © The American Regenerative Medicine Society

Dr. Jason Pirozzolo is the Director of Sports Medicine and Trauma at Orlando Hand Surgery Associates and Orlando Regenerative Medicine Center. He specializes in non-surgical orthopedic treatments, regenerative medicine and platelet rich plasma injections. He is also the President of The American Regenerative Medicine Society and serves on the Board of Governors at the Florida Medical Association and as a delegate to the American Medical Association.

References

  1. Loibl M, Lang S, Dendl LM, et al. Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study. Biomed Res Int. 2016;2016:9262909. doi:10.1155/2016/9262909
  2. Steiner MM, Calandruccio JH. Biologic Approaches to Problems of the Hand and Wrist. Orthop Clin North Am. Jul 2017;48(3):343-349. doi:10.1016/j.ocl.2017.03.010
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finger arthritis platelet rich plasma orlando hand surgery

Finger Arthritis and Platelet Rich Plasma Treatments

Orlando, Florida – Finger arthritis is one of the most common forms of osteoarthritis, and the prevalence is expected to increase as the population ages.1 Finger arthritis causes pain, loss of function, decreased ability to grip objects with the hand, and it reduces overall quality of life.1 Healthcare professionals can diagnose finger osteoarthritis through a detailed history and physical examination along with radiological studies, such as hand x-rays.

Finger osteoarthritis may be caused by a single major injury or repetitive use, i.e., small injuries that accumulate over time.2 For example, NBA player Kobe Bryant has severe osteoarthritis in his right index finger. He likely developed the condition from a combination of major injury and continued, repetitive use while playing basketball.

Finger Arthritis and Platelet Rich Plasma Treatments

The current goal of finger osteoarthritis treatment is to alleviate symptoms such as pain. Thus, nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed treatment. NSAIDs may be taken orally or applied topically. Likewise, topical capsaicin has also been used to treat finger osteoarthritis. While splints, the application of heat or ice, and even assistive devices have been tried, they result in little to no improvement.1Physical therapy exercises may decrease pain and increase strength and range of motion. Unlike rheumatoid arthritis, there are no disease modifying drugs available for finger osteoarthritis.1 Occasionally, steroid injections may be used to treat finger osteoarthritis, but their benefits are limited.1 If nonsurgical treatments fail to provide adequate relief, surgery may be attempted.

An interesting new treatment for osteoarthritis of the finger is platelet rich plasma. “Platelet rich plasma therapy is a way of administering concentrated healing factors into the arthritic joint to facilitate healing, reduce pain, and improve outcomes,” reports Dr. Jason Pirozzolo, a sports medicine physician in Orlando, Florida and President of the American Regenerative Medicine Society. “Platelet rich plasma is not a drug in the normal sense. Instead, physicians retrieve a sample of blood from the patient and, using a centrifuge, isolate the layer that contains platelets and growth factors. The sample is then injected back into the patient’s own finger joint.”

Initial results with platelet rich plasma have been promising.3 Patients with arthritis of the thumb had less pain and increased strength and function after PRP.4

Finger arthritis is a potentially debilitating disorder of the joints. It can result from injury, repetitive use, or both. Conservative treatments such as splints, heat therapy, or steroid injections are only marginally helpful. “Surgery may be needed for severe and intractable finger arthritis, therefore patients with finger arthritis may want to consider platelet rich plasma therapy as a possible treatment option,” says Pirozzolo.

 

Authored by © The American Regenerative Medicine Society

Dr. Jason Pirozzolo is the Director of Sports Medicine and Trauma at Orlando Hand Surgery Associates and Orlando Regenerative Medicine Center. He specializes in non-surgical orthopedic treatments, regenerative medicine and platelet rich plasma injections. He is also the President of The American Regenerative Medicine Society and serves on the Board of Governors at the Florida Medical Association and as a delegate to the American Medical Association.

References

  1. Kloppenburg M. Hand osteoarthritis-nonpharmacological and pharmacological treatments. Nat Rev Rheumatol. Apr 2014;10(4):242-251. doi:10.1038/nrrheum.2013.214
  2. Verrouil E, Mazieres B. Etiologic factors in finger osteoarthritis. Rev Rhum Engl Ed. Jun 1995;62(6 Suppl 1):9s-13s.
  3. Steiner MM, Calandruccio JH. Biologic Approaches to Problems of the Hand and Wrist. Orthop Clin North Am. Jul 2017;48(3):343-349. doi:10.1016/j.ocl.2017.03.010
  4. Loibl M, Lang S, Dendl LM, et al. Leukocyte-Reduced Platelet-Rich Plasma Treatment of Basal Thumb Arthritis: A Pilot Study. Biomed Res Int. 2016;2016:9262909. doi:10.1155/2016/9262909
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Platelet Rich Plasma Therapy for Shoulder Impingement, Bursitis, Tendonitis

Platelet Rich Plasma for Shoulder Impingement, Bursitis, Tendinitis

Orlando, Florida – Shoulder impingement syndrome is a collection of shoulder symptoms related to impingement, bursitis, and tendinitis in and around the shoulder joint. The most common symptom of shoulder impingement is pain, especially when one tries to use the affected arm above the level of the head (e.g., overhead activity, throwing). There may be pain over the deltoid muscle or the outside of the upper arm as well.1 Since shoulder impingement syndrome includes inflammation of the bursa, rotator cuff, biceps tendon, and labrum, the physical examination findings are extensive. Physicians often find evidence of shoulder bursitis and tendinitis along with generalized pain and inflammation. X-rays, ultrasound, or MRI may be used to confirm the diagnosis or rule out other possible causes of shoulder pain.

shoulder impingment bursitis tendonitis

Shoulder impingement syndrome is quite common in serving or throwing athletes, such as tennis players, volleyball players, and baseball pitchers. In fact, shoulder impingement, bursitis, and tendinitis are extremely common among major-league baseball pitchers. One of the most common reasons for a trip to the disabled list for pitchers in that sport is related to problems with shoulder tendons and joints. Take one MLB team for example, the Baltimore Orioles. Pitchers Zach Britton, Mike Wright, Chris Tillman, Wade Miley made trips to the DL for shoulder bursitis and tendinitis (not to mention catcher Wellington Castillo and third baseman Ryan Flaherty.) In fact, Chris Tillman recently underwent platelet rich plasma therapy as part of his shoulder rehab. Spread across the rest of MLB, professional tennis, and other pro sports, the number of athletes affected by shoulder impingement syndrome is remarkable.

Treatment for acute shoulder impingement (i.e., severe symptoms occurring over short period of time) is rest, ice, and NSAIDs. After several days, physical therapy may be added to treatment. Steroid injections may occasionally be used to reduce tendinitis and bursitis inflammation. People with shoulder impingement may require orthopedic surgery if there are obvious structural problems in the shoulder joint such as a full thickness rotator cuff tear.1,2

An exciting new approach to the treatment of shoulder impingement syndrome with associated bursitis and/or tendinitis is platelet rich plasma therapy. “Platelet rich plasma therapy or PRP is an individualized treatment in which we use the patient’s own blood as the source of an injectable treatment,” reports Dr. Jason Pirozzolo, a sports medicine physician in Orlando, Florida and President of the American Regenerative Medicine Society. “We draw a small quantity of blood from a vein and then isolate and concentrate various natural healing factors in the plasma portion of the blood sample. The PRP sample contains blood platelets, cytokines, growth factors, and other molecules that facilitate and speed up healing.”

Platelet rich plasma therapy has been increasingly used to treat shoulder impingement syndrome. Some clinical studies have shown PRP injection to be effective at reducing pain and disability in people with shoulder impingement syndrome.4

Shoulder impingement syndrome with accompanying bursitis and tendinitis is a painful disorder that can interfere with sports and daily activities. “Professional athletes, weekend warriors, and patients of all ages are increasingly using PRP as part of their rehab and treatment for shoulder impingement,” states Pirozzolo.

 

Authored by © The American Regenerative Medicine Society.

Dr. Jason Pirozzolo is the Director of Sports Medicine and Trauma at Orlando Hand Surgery Associates and Orlando Center for Regenerative Medicine. He specializes in non-surgical orthopedic treatments, regenerative medicine and platelet rich plasma injections. He is also the President of The American Regenerative Medicine Society and serves on the Board of Governors at the Florida Medical Association and as a delegate to the American Medical Association.

 

To schedule a regenerative medicine consultation with Dr. George WhiteDr. Jason PirozzoloDr. Brian White, or Dr. Anup Patel, call (407) 841-0001. Our center is conveniently located in the same building as our Orlando Hand Surgery Associates Downtown Orlando office at 801 N. Orange Ave., Suite 530, Orlando, FL 32801.

 

References

  1. Meister K. Internal impingement in the shoulder of the overhand athlete: pathophysiology, diagnosis, and treatment. Am J Orthop (Belle Mead NJ). Jun 2000;29(6):433-438.
  2. Mehta S, Gimbel JA, Soslowsky LJ. Etiologic and pathogenetic factors for rotator cuff tendinopathy. Clin Sports Med. Oct 2003;22(4):791-812.
  3. Andia I, Abate M. Platelet-rich plasma: underlying biology and clinical correlates. Regen Med. Sep 2013;8(5):645-658. doi:10.2217/rme.13.59
  4. Nejati P, Ghahremaninia A, Naderi F, Gharibzadeh S, Mazaherinezhad A. Treatment of Subacromial Impingement Syndrome: Platelet-Rich Plasma or Exercise Therapy? A Randomized Controlled Trial. Orthop J Sports Med. May 2017;5(5):2325967117702366. doi:10.1177/2325967117702366

 

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Platelet Rich Plasma Therapy for Arthritis | Dr. Jason Pirozzolo

At the Orlando Center for Regenerative Medicine, we commonly use platelet rich plasma therapy for arthritis in the hand, wrist, elbow, shoulder, hip, knee, ankle and foot. Dr. Jason Pirozzolo explains arthritis, and how platelet rich plasma therapy can be used for this common condition as a surgery and steroid alternative, in the video listed. Watch the video and read below to learn more.

What is Arthritis?

Arthritis is a progressively debilitating condition that eventually affects nearly everyone in one way or another. Essentially, arthritis is the wearing away of joint cartilage over time that leads to pain, swelling, and loss of function.

Early Treatments for Arthritis

Arthritis can affect any joint, but it is most commonly associated with the shoulder, hand, wrist, and knee. When arthritis pain does become a problem, early treatments include corticosteroid injections and oral medication, along with activity modification and physical therapy.

Eventually, these conservative therapies become less effective over time, and many patients are presented with a surgical option of a joint replacement. Until recently, that was the treatment of course typically followed by millions of patients, but now we have an alternative. What has been thrust into the spotlight by world-class athletes and is now available to everyone is platelet rich plasma, or PRP therapy.

What is Platelet Rich Plasma Therapy?

Platelet rich plasma is obtained from your own blood. The blood is placed in a specialized tube and then treated by a centrification process, using a proprietary filtration process, which separates and concentrates your own platelet rich plasma.

platelet rich plasma patient success story

Watch one patient’s story with platelet rich plasma therapy for arthritis in her hands.

How Does PRP Therapy Work?

Scientists have identified different growth factors that promote the regeneration of bone, cartilage and tendons. Growth factors found in your platelets include: platelet derived growth factor, insulin like growth factor, vascular endothelial growth factor, platelet derived angiogenic growth factor, and transforming growth factor beta. These growth factors are activated upon injection of your platelet rich plasma.

Can PRP Therapy Work For Arthritis?

In March 2016 a systematic review of the literature was published and analyzed the outcome of patients with arthritis that were treated with platelet rich plasma (PRP) therapy. They concluded that there was a significant clinical improvement in those patients treated with PRP for up to 12 months post injection.

An ongoing study presented at the American Association of Orthopaedic Surgeons (AAOS) Annual Meeting compared the efficacy of platelet rich plasma injections vs. corticosteroid injection(s) for pain relief, functional return and improved range of motion in patients with carpometacarpal joint osteoarthritis. The study showed that after a 6-month follow-up, patients who received PRP showed a 90% decrease in pain from baseline. Patients who received corticosteroid injections showed an 8% increase in pain from baseline. Researchers found that compared to corticosteroid injections, PRP injections show merit for treatment of carpometacarpal joint osteoarthritis.

To schedule a regenerative medicine consultation with Dr. George White, Dr. Jason Pirozzolo, Dr. Brian White, or Dr. Anup Patel, call (407) 841-0001. Our center is conveniently located in the same building as our Orlando Hand Surgery Associates Downtown Orlando office at 801 N. Orange Ave., Suite 530, Orlando, FL 32801.

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PRP Therapy: What to Expect | Dr. Brian White

PRP (platelet rich plasma) therapy is an innovative nonsurgical treatment option used to activate healing in an area of injury and/or pain in the body. Unlike surgery or steroid injections, PRP therapy is a minimally invasive procedure that consists of only using a concentrated source of the patient’s own blood as the healing agent.

PRP therapy first gained headlines when high-level athletes (such as Kobe Bryant, Rafael Nadal, and Steph Curry) used the procedure for their joint pain. Thanks to recent advancements in regenerative medicine, we can now offer PRP therapy to all of our patients who are a good candidate for the procedure.

Our expert team of doctors at Orlando Hand Surgery Associates provide nonsurgical regenerative medicine procedures at our new facility, Orlando Center for Regenerative Medicine. The Orlando Center for Regenerative Medicine houses state-of-the-art technology for our procedures and it’s conveniently located in the same building as our Orlando Hand Surgery Associates Downtown Orlando office at 801 N. Orange Ave., Suite 530, Orlando, FL 32801.

Before making an appointment for a PRP injection, you will first have a consultation with one of our doctors. Our doctors take an individualized approach for each specific injury and condition in order to determine the best treatment plan for your situation. If PRP therapy is the best treatment option for you, our office will schedule an appointment for the procedure.

Anti-inflammatories should not be taken for 3 weeks prior to the procedure and 3 weeks after the procedure. A PRP therapy procedure begins with one of our registered nurses drawing your blood. Approximately 60 cc’s of blood is drawn; about the same amount you would expect to give for a blood donation.

Platelet Rich Plasma Concentration System (via Biomet) Orlando Center for Regenerative Medicine

Platelet Rich Plasma Concentration System (via Biomet Biologics)

The blood is then spun in a high-spinning machine called a centrifuge. The centrifuge separates the blood into 3 components: red bloods cells, platelet rich plasma, and platelet poor plasma. The platelet rich plasma component includes growth factors that can promote healing and relieve pain. Therefore, only the concentrated source of platelet rich plasma is injected into the area of pain and discomfort.

Many patients report that the injection is painless and most patients are able to return to normal daily activities immediately after the procedure. Patients typically start seeing an improvement in their mobility and symptoms within 2 to 4 weeks. Depending on the severity of the injury or condition, more than one injection may be required.

A wide range of conditions and injuries of the shoulder, elbow, wrist, hand, hip, knee, ankle and foot can be treated using PRP therapy at the Orlando Center for Regenerative Medicine.

To schedule a regenerative medicine consultation with Dr. George White, Dr. Jason Pirozzolo, Dr. Brian White, or Dr. Anup Patel call (407) 841-0001. To learn more about PRP therapy, or other regenerative medicine procedures, please visit OrlandoRegenerativeMed.com.

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Patient Success Story | Platelet Rich Plasma Therapy for Hand Pain

When Marilyn hit her retirement, she set out to stay more active than ever before. She planned on filling her days with activities such as swimming, rowing, biking, pottery, and playing with her grandkids. She finally had the freedom to do all the activities she loves, but there was only one thing standing in here way: osteoarthritis. “I’ve dealt with arthritis in my feet and knees before, but it wasn’t until I had osteoarthritis in my hands that everything changed,” says Marilyn. “I need my hands to do so many things that I enjoy doing.”

Patient Success Story | Platelet Rich Plasma Therapy for Hand PainWhat is Osteoarthritis?

Osteoarthritis is a common form of arthritis that causes the joints to degenerate. According to the Arthritis Foundation, osteoarthritis affects approximately 27 million Americans. Osteoarthritis can affect any joint, but it most commonly occurs in the knees, hands, wrists, and shoulders.

The most common forms of treatment for osteoarthritis include activity modification, rehabilitation, steroid injections, and in severe cases, surgery. “For a decade, I received steroid injections in my hands to relieve pain, and while they worked for a while, I wanted a more long-term option that didn’t include surgery, so I scheduled an appointment with Dr. Jason Pirozzolo at Orlando Hand Surgery Associates,” says Marilyn.

“When I first met Marilyn she came to see me after having repeated steroid injections into her finger for severe arthritis; she was having problems bending her fingers, and she was having significant pain,” says Dr. Jason Pirozzolo. “Over time, steroid injections can lose their effectiveness however, and that’s why we offered her a different treatment option: platelet rich plasma, which is PRP.”

What is Platelet Rich Plasma (PRP) Therapy?

A platelet rich plasma (PRP) therapy procedure begins with drawing the patient’s blood. The blood is placed in a specialized tube and then spun in a centrifuge. The centrifuge separates the blood into three components: platelet rich plasma, platelet poor plasma, and red blood cells. The doctor only uses the platelet rich plasma component to inject in the area of injury or pain. Watch a video on what to expect during a platelet rich plasma (PRP) therapy procedure here.Patient Success Story | Platelet Rich Plasma Therapy for Hand Pain

Platelet Rich Plasma (PRP) Therapy for Osteoarthritis

 “We believe platelet rich plasma works by stimulating cartilage matrix production. In addition, platelet rich plasma can help to modulate the inflammatory response. Doing both of those things in the setting of osteoarthritis may result in a reduction of pain and an improvement in function,” says Dr. Jason Pirozzolo.

What are the benefits of using platelet rich plasma (PRP) therapy?

  • The procedure is minimally invasive.
  • There’s minimal risk involved as the procedure consists of only using your own blood.
  • Many patients can resume normal daily activities almost immediately after the procedure.
  • Quicker recovery and rehabilitation time when compared to surgery.

After her first platelet rich plasma injection, Marilyn noticed a significant improvement in her pain and function. She’s now back to making pottery for her friends and family and doing the activities she loves. Watch Marilyn share her story with platelet rich plasma (PRP) therapy by watching the video above.

Dr. Jason Pirozzolo, Dr. George White, Dr. Brian White and Dr. Anup Patel perform platelet rich plasma (PRP) therapy and stem cell therapy procedures at the Orlando Center for Regenerative Medicine, located in the same building as our Orlando Hand Surgery Associates downtown Orlando location. Learn more about the regenerative medicine procedures we offer here: http://orlandoregenerativemed.com/.

 

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