All Posts Tagged: prp

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.

Request an appointment

Read More
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
Read More
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
Read More
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

 

Read More
PRP Therapy Surgery Alternative OHSA

OHSA Now Offering PRP Therapy

Orlando Hand Surgery Associates now offers Platelet Rich Plasma (PRP) therapy as a new surgery alternative for those dealing with chronic pain and injuries. With PRP therapy you can use the power of your own body to activate healing.

WHAT IS PRP THERAPY?

Platelets and growth factors found in our body are known for their importance in the healing process during an injury. A PRP procedure consists of drawing the patient’s own blood and using a centrifuge to separate the platelets and growth factors from other blood plasma. After separation is complete, the concentrated source of platelet-rich plasma is then injected into the area of pain or injury to activate natural healing within the body.

HOW IS PRP OBTAINED?

prp therapy orlando hand surgery

HOW LONG DOES THE PROCEDURE TAKE?

A typical procedure may take anywhere from 45 to 90 minutes. In most cases, patients were able to return to their job, or usual activities, immediately after the procedure.

WILL MY BODY REJECT PRP?

There is little to no chance that your body will reject PRP as the procedure consists of using your own blood.

WILL MORE THAN ONE INJECTION BE REQUIRED?

While many patients receive relief after the first or second PRP injection, the amount of injections needed will depend on the severity of the injury or condition.

WHICH UPPER EXTREMITY INJURIES OR CONDITIONS CAN BE TREATED WITH PRP?

Chronic joint pain, tennis & golfers elbow, rotator cuff injuries, ligament tears, osteoarthritis, acute muscle injuries, and much more.

Watch one patient’s PRP therapy success story:

Want to learn more about PRP therapy? Request an appointment online or give us a call at (407) 841-2100.

Read More