Thursday, 17 of January of 2019

Tag » bursitis

Update on PRP & Other Injections



If you have chronic tendonitis in your elbow, knee pain from osteoarthritis, or bursitis in your hip, cortisone injections are an effective treatment that can reduce inflammation and discomfort. Now PRP or platelet-rich plasma is another type of injection that is gaining popularity as a way to reduce pain and disability prior to considering surgery.

The December Journal of the American Association of Orthopedic Surgeons and the November 14 issue of New Yorker magazine both featured the latest information about PRP. Here’s what the publications had to say about this high-tech, advanced treatment that Dr. Kagan has been offering for some time.

In the New Yorker article, Chris Waddell, a star athlete who is a paraplegic and the most decorated male skier in Paralympic history, talks about the major improvement PRP had on his shoulder injuries – a torn rotator cuff in one shoulder and a torn biceps tendon in the other shoulder. He says the successful treatment helped him regain his shoulder strength and decreased his pain almost 100 percent. But most importantly, it helped him avoid surgery.

How safe and effective is PRP? There are many opinions on PRP’s ability to accelerate healing and enhance tissue recovery. Whether you may benefit is a decision best made in a one-on-one consultation with a physician who is experienced in using the technique. PRP takes the patient’s own blood and separates the red and white blood cells from the platelets. Platelets have both clotting and growth factors, which are vital for healing. To treat the injury, a concentrated mix of platelets is injected into the joint, ligament or tendon.

In the AAOS journal articles, Dr. Scott Rodeo of Weill Medical College of Cornell University and Dr. Freddie Fu of the University of Pittsburgh School of Medicine express some caution. They suggest that PRP is a promising treatment option that may offer symptomatic relief in tendonitis and osteoarthritis, but recommend additional scientific research before it can be considered a proven therapy. The doctors recommended PRP as a “second line of defense” when other nonsurgical options have not been effective.

For more information about PRP and other treatment options for orthopedic-related injuries, go to, or call the office at 239-936-6778 to schedule a consultation.

Shoulder Injuries – What to Expect



Football injuriesAs football season moves into full swing across the country, shoulder injuries are inevitable, whether players are NFL pros, college or high school athletes. Most of the time, injuries come from contact with another player as a result of a tackle, block or collision or fall to the ground. Even though players wear protective gear, rotator cuff injuries, sprains, strains, contusions and fractures are common shoulder injuries that can be sustained during the game or practice.

The American Academy of Orthopedic Surgeons describes the shoulder as several joints that combine with tendons and muscles to allow you to move your arm in a wide range of motion. Of course, this also makes the shoulder prone to injury.

But it’s not only football athletes who can suffer from a shoulder-related problem. The discomfort of bursitis, tendinitis or tendon tears, shoulder instability, impingement and osteoarthritis can affect anyone of any age or athletic ability.

If your shoulder is giving you chronic trouble, making it difficult to lift your arm or the pain wakes you up at night, don’t put off scheduling an evaluation to determine the cause and best treatment plan.

What can you expect during a consultation?

In addition to a physical exam, the doctor may order an X-ray or arthrogram, which involves injecting dye into the shoulder to help better visualize the joint and surrounding tissue. Sometimes, diagnostic imaging tests such as, CT Scan, ultrasound or MRI, may be required if the doctor wants to gain a more detailed picture of the anatomy, especially of the muscles, ligaments and tendons. Arthroscopy, which uses a tiny video-camera to allow the doctor to see inside the joint, can be used for both diagnostic evaluation and surgical repair of the problem.

For more information about shoulder pain or other orthopedic injuries, go to or call the office at 239-936-6778 to schedule a consultation.

Could Bursitis Be The Cause of Your Hip, Knee or Elbow Pain?



shutterstock_111719057Just like cartilage acts as a cushion between two bones, small jelly-like sacs called bursa act as a cushion between bones and muscles. Irritation and inflammation of the bursa in the shoulder, elbow, hip, knee and heel is fairly common, but that doesn’t make bursitis any easier to tolerate.  

What causes bursitis? Typically, it result from repetitive movements that stress the joint. Think of carpenters sawing lumber, painters kneeling for a long time to pain a baseboard, gardeners weeding or trimming bushes, musicians strumming a guitar and athletes pitching or throwing a ball. All of these activities increase the risk for bursitis.

How do you know if you have bursitis? The American Academy of Orthopedic Surgery repots that for hip bursitis, the pain usually begins at the point of the hip and spreads to the outside of the thigh area. It may be worse at night if you sleep on the affected hip and can also be painful after long periods of walking, squatting or climbing stairs. 

Medications to control inflammation and discomfort can be helpful, as can cortisone injections. Although it’s not a commonly performed procedure, some doctors remove a chronically inflamed bursa through arthroscopic surgery.

The Mayo Clinic offers the following prevention tips:

  • When possible, avoid repetitive activities that worsen the discomfort.
  • Take frequent breaks when performing repetitive tasks.
  • Use a cushion to protect joints, such as knee pads and elbow pads.
  • Increase the gripping surface on tools by using gloves, grip tape, or other padding.
  • Use an oversized grip on golf clubs and a two-handed backhand in tennis.
  • Use two hands to hold heavy tools.
  • Don’t sit still for long periods.

To schedule a consultation with Dr. Kagan,  call 239-936-6778 or go to for more information on orthopedic-related concerns.

Causes of Hip Pain

The first step in treating hip pain is to determine the cause. Your age, level of activity, gender and medical history are important clues in helping the doctor diagnose the source of persistent aches and pains. For example, someone in their 20s or 30s is more prone to certain types of medical conditions than someone in their 70s or 80s.

The four most common causes of hip pain include:

Osteoarthritis. Former president George H.W. Bush, singer Billy Joel and Olympic skater Rudy Galindo are among the millions of people who have received a hip replacement due to osteoarthritis, a painful condition that causes inflammation and breakdown of the cartilage in the hip joint.

Hip Fractures. Ninety percent of all hip fractures in the U.S. are the result of falls, says the American Academy of Orthopedic Surgery. In addition, women are two to three times more likely to have a hip fracture than men. That’s because women are more likely to develop osteoporosis, a degenerative condition that weakens the bones and makes them more brittle. It takes a lot to break a hip bone – except when it’s been damaged by osteoporosis.

Bursitis. Repetitive stress on the hip joint from sports such as running and bicycling, work that requires standing for long periods of time, and even gardening or stair climbing can irritate and inflame the bursa. The bursa is a small fluid-filled sac that cushions the muscles and the bones in the hip. If you have bursitis, the pain may be worse after you’ve been sitting for long periods of time or it may wake you up at night if you happen to lie on the affected hip.

Muscle Strains and Tendonitis. Overdoing it in sports, training errors, excessive stretching, or sudden increases in the level of activity can stress the hip tendons beyond capacity or tear the muscle fibers, causing pain and swelling and loss of strength. The AAOS offers these easy suggestions to prevent muscle strains or tendonitis: warm up before stretching, stretch slowly, wear the right shoe for the sport and participate in a conditioning program that builds muscle fitness and flexibility.

Treatment for hip pain may range from rest, ice and over-the-counter medication to surgery. For a list of painful hip conditions that require surgical intervention by an orthopedic surgeon, go to

Good News for Bursitis Sufferers

While the warm weather may beckon you outside, activities such as gardening or exercise may cause swollen and aching joints, which should not be ignored. A common cause of painful hips, knees, heels and elbows, bursitis results from inflamed or infected fluid-filled sacs or bursae that surround the joints. Prompt medical attention by an orthopaedic doctor can help you get to the source of the pain and treatment options to help alleviate it. Since bursitis symptoms resemble other joint problems such as arthritis or ligament injuries, a thorough evaluation by a trained orthopaedic surgeon is the best option. If bursitis is diagnosed, your physician can determine whether infection is involved and prevent it from spreading.

Typical symptoms of bursitis include:

  • Pain with or without joint movement
  • Swelling of the area surrounding the joint
  • Redness of the skin near the joint
  • Warmth of the area near the joint
  • Pain or tenderness when the bursa is touched

All types of bursitis often can be successfully managed non-surgically, and possible treatments include:

  • Use of ice packs or compressive dressings
  • Activity modification that may reduce stress or irritation
  • Administration of nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics
  • Corticosteroid injections (knee and elbow)
  • Stretching exercises
  • Change of footwear (heel).

Surgery may be required in patients whose symptoms remain following these treatments and in certain situations when infection is involved. An accurate diagnosis is important to determine the best treatment options to help the patient resolve pain and other symptoms and regain mobility and quality of life.

If you are suffering with joint pain, contact Dr. Kagan at 239-936-6778. Visit or for more resources.

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