REPAIR - RECOVER - REGENERATE Feel better. Move better. Live better.
REPAIR - RECOVER - REGENERATE Feel better. Move better. Live better.
Overview
Knee osteoarthritis is a common condition where the protective cartilage that cushions the bones of your knee gradually wears down. As the cartilage becomes thinner and rougher, the space between the bones narrows, causing the bones to rub against each other. This can lead to pain, stiffness, swelling, and the development of bony growths called bone spurs. Although more common in adults over 50, younger people can also develop osteoarthritis. Especially in instances of injury, heavy joint use, or genetic predisposition.
Symptoms
Knee osteoarthritis usually develops slowly and gets worse over time. Common symptoms include:
Symptoms may come and go but often become more persistent as the condition progresses.
Diagnosis
A diagnosis of knee osteoarthritis is based on:
Medical History
Understanding your symptoms, lifestyle, previous injuries, and how long discomfort has been present.
Physical Examination:
Your clinician will assess swelling, range of motion, tenderness, joint stability, and walking pattern.
Imaging (if needed)
These tests help rule out other causes of knee pain and confirm the extent of the osteoarthritis.
Treatment Options
Treatment focuses on reducing pain, improving mobility, and slowing progression. Options may include:
1. Lifestyle & Conservative Care:
2. Medications:
3. Image‑Guided Injections:
At your clinic, this may include:
4. Surgical Options (Last Resort)
If symptoms remain severe despite non‑surgical treatments, a knee replacement may be considered. However most patients benefit from conservative care.
When to Seek Care
You should seek medical evaluation if you experience:
Early care can slow progression and significantly improve comfort.
FAQs
Is knee osteoarthritis reversible?
While cartilage loss cannot be reversed, symptoms can be significantly reduced with the right treatment plan.
Do I need imaging to diagnose osteoarthritis?
Not always. Many cases can be diagnosed through history and examination, but imaging may help confirm severity.
Can exercise make arthritis worse?
No — the right exercises actually help support the joint, reduce pain, and improve function.
Are injections safe?
Image‑guided injections used at your clinic are safe and targeted, helping relieve pain without surgery.
Will I eventually need a knee replacement?
Not necessarily. Many people manage symptoms long‑term with non‑surgical treatments and lifestyle adjustments
Overview
Shoulder pain is a common problem that can arise from irritation, inflammation, or injury to the many structures that work together to move the shoulder. These include tendons, ligaments, muscles, bones, and small fluidfilled sacs called bursae.
Common causes of shoulder pain include:
Less common causes include infection, nerve problems, or tumors.
Symptoms
Shoulder symptoms will vary based on the underlying cause, but may include:
Some conditions, such as bursitis or tendinitis, cause sharp pain with movement. Others, such as arthritis, cause gradual stiffness and aching over time.
Diagnosis
Diagnosis usually begins with a careful history and physical exam.
Examination
Your clinician will assess:
Imaging (if needed)
Depending on your symptoms, one or more tests may be recommended:
Most soft tissue conditions can be diagnosed with an exam + ultrasound.
Treatment Options
Most shoulder problems improve with nonsurgical treatment.
1. Activity Modification & Physiotherapy
Physiotherapy is one of the most effective firstline treatments.
2. Medications
Anti-inflammatory medications (NSAIDs) may help relieve pain and reduce inflammation when appropriate.
3. Injections
Injections can help when pain persists despite rest and physiotherapy.
Cortisone Injections
These reduce inflammation quickly and can give temporary relief, but repeated cortisone injections may weaken tissues over time.
PlateletRich Plasma (PRP) Injections
PRP uses your own blood, processed to concentrate platelets rich in healing growth factors.
It is increasingly used for:
Recent evidence supporting PRP:
Shoulder Osteoarthritis (2023 Randomized Controlled Trial):
A doubleblinded RCT found PRP significantly improved pain scores compared to saline for shoulder osteoarthritis, with better outcomes at followup and fewer postinjection symptoms.
[academic.oup.com]
PartialThickness Rotator Cuff Tears (2024 RCT):
A 2024 RCT showed PRP (with or without vitamin C) produced significant pain reduction and functional improvement, confirming PRP as an effective nonsurgical option within 3 months.
[link.springer.com]
Rotator Cuff Tendinopathy (2024 Review):
A 2024 review highlighted PRP as a growing treatment for rotator cuff tendinopathy, showing potential benefits—especially for patients seeking nonsurgical options.
[jointdrs.org]
4. Surgery
Surgery is only recommended when:
Most patients improve without surgery.
When to Seek Care
You should see a clinician if:
Early treatment prevents worsening symptoms and promotes better recovery.
FAQs
Is shoulder pain always caused by a tear?
No. Many cases are due to inflammation, irritation, or impingement—not structural damage.
Do I need an MRI?
Not always. Many shoulder problems can be diagnosed with a careful exam X-rays and ultrasound.
Is PRP effective for shoulder conditions?
Yes. Recent studies show PRP can improve pain and function in:
How long does shoulder healing take?
It depends on the cause. Tendinitis may improve in weeks, while tendon healing or arthritis management can take several months.
Will I need surgery?
Most patients improve without surgery. It is only considered when other treatments have not worked.
Overview
Greater Trochanteric Pain Syndrome (GTPS) is a common cause of pain on the outer (lateral) side of the hip. It occurs when the structures that sit over the bony point of the hip (the greater trochanter) become irritated or inflamed.
Several issues can contribute to GTPS, including:
GTPS is especially common in women and people in mid to later adulthood, but it can affect anyone.
Symptoms
The main symptom of GTPS is pain on the outer side of the hip, which may extend down the outside of the thigh.
Patients often describe:
These symptoms may come and go or become more persistent over time.
Diagnosis
Diagnosing GTPS usually involves:
Medical History
You’ll be asked about your symptoms, daily activities, any recent injuries, and other medical conditions.
Physical Examination
Your clinician may press on the side of the hip to identify tender areas and assess hip movement or gait patterns.
Imaging (if needed)
Most cases are diagnosed through examination alone.
Treatment Options
Most people with GTPS improve with nonsurgical care. Treatment may include:
1. Lifestyle Changes & Selfcare
2. Therapeutic Injections
If symptoms persist, image-guided injections can provide targeted relief.
Types of injections include:
Cortisone Injection
A traditional treatment that delivers a strong anti-inflammatory medication directly to the irritated area.
Pros: Fast pain relief
Cons: Possible risks include tendon weakening or rupture, fat atrophy, and recurrence of symptoms
PlateletRich Plasma (PRP)
A newer treatment that uses your own blood, processed to concentrate healing platelets.
PRP may provide longer-lasting improvement without the side effects associated with cortisone.
Research suggests PRP can be more effective and provide longer relief compared to cortisone for GTPS.
When to Seek Care
You should consider medical evaluation if:
Early treatment can prevent worsening symptoms and speed recovery.
FAQs
Is GTPS the same as hip bursitis?
GTPS often includes bursitis, but it can also involve tendon irritation or referred pain from the back.
Can GTPS go away on its own?
Some cases improve with rest and activity changes, but many benefit from targeted treatment and physiotherapy.
Are injections always necessary?
No. Many people improve with conservative care, but injections can help if symptoms remain stubborn.
Is PRP safer than cortisone?
PRP avoids the potential tendon-weakening effects of cortisone and may offer longer-lasting relief.
Can GTPS lead to hip arthritis?
GTPS itself does not cause arthritis, but both conditions can occur together.
Overview
Plantar fasciitis is one of the most common causes of heel pain. The plantar fascia is a strong, thin band of tissue that runs along the bottom of your foot, connecting your heel to the front of your foot and supporting your arch.
When this band becomes irritated or inflamed, it causes stabbing or aching heel pain, especially with your first steps in the morning. Plantar fasciitis affects 3.6–7% of the general population and is even more common in runners. Although heel spurs are often found on X-rays, they do not usually cause pain.
Symptoms
People with plantar fasciitis commonly experience:
Pain may gradually worsen over weeks or months if untreated.
Diagnosis
Plantar fasciitis is usually diagnosed through:
Clinical Examination
Your clinician will assess the foot for tenderness, tightness, and alignment. Pain is typically felt when pressing on the heel or stretching the plantar fascia.
Imaging (if needed)
Tests such as X-rays or ultrasound may be ordered to rule out stress fractures, tendon injuries, or other causes of heel pain. In most cases, imaging is not necessary.
Treatment Options
Most people improve with simple, nonsurgical treatments. About 90% of patients feel better within 4-6 months.
1. Conservative (NonSurgical) Treatment
Common options include:
2. Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may help reduce pain and inflammation (please check with your family doctor if you are allowed to take NSAID).
If used for more than one month, this should be reviewed by your doctor.
3. Surgery (Rarely Needed)
Surgery is only considered after 12 months of persistent pain despite thorough nonsurgical treatment.
4. Injections for Plantar Fasciitis
If symptoms do not improve with conservative care, injections may be considered. Ultrasound-guided injections ensure accuracy and comfort.
Cortisone Injection
A traditional treatment that delivers strong anti-inflammatory medication to the painful area.
Benefits:
Risks:
Platelet Rich Plasma (PRP) Injection
A regenerative treatment that uses a patient’s own blood, processed to concentrate healing platelets. These are injected into the plantar fascia to promote natural tissue repair.
Benefits:
Research findings:
When to Seek Care
You should seek medical assessment if:
Early treatment prevents chronic pain and speeds recovery.
FAQs
Do heel spurs cause plantar fasciitis?
No. Heel spurs are common and usually painless. Most people with heel spurs have no symptoms.
Can plantar fasciitis heal on its own?
Yes, many cases improve with stretching, footwear changes, and time. However, treatment can shorten recovery significantly.
Is PRP better than cortisone?
Research shows PRP offers longer-lasting relief and avoids the risks associated with cortisone injections.
Should I stop exercising?
High impact activities (running, jumping) may worsen symptoms, but gentle exercise and stretching are beneficial.
Do I need orthotics?
Orthotics can improve support and reduce strain on the plantar fascia. Many patients experience significant relief with proper footwear and inserts.
Overview
Lateral Epicondylitis, commonly known as Tennis Elbow, is a condition caused by irritation or degeneration of the tendons that attach to the outside of the elbow. The main tendon involved is the extensor carpi radialis brevis (ECRB), which helps lift and straighten the wrist.
This condition is often related to repetitive strain, gripping, or lifting, and is most common in adults aged 30 to 60. Despite its name, many people develop it from work or daily activities, not necessarily from playing tennis.
Symptoms
Tennis elbow symptoms usually develop gradually. Common symptoms include:
Although the elbow may hurt, most patients maintain full range of motion.
Diagnosis
Tennis elbow is usually diagnosed through:
Medical History
Discussion of symptoms, daily activities, and any repetitive tasks or injuries.
Physical Examination
Your clinician will examine the elbow for tenderness, test wrist and forearm strength, and look for movements that reproduce the pain.
Imaging (only if needed)
Most patients do not require imaging. However, X-rays, ultrasound, or MRI may be recommended if symptoms are unusual or if another condition needs to be ruled out.
Treatment Options
Most people recover without surgery. Treatment focuses on reducing pain, healing the tendon, and improving strength.
1. Rest & Activity Modification
2. Medications
3. Physical Therapy
Specific exercises help strengthen the wrist and forearm muscles and promote tendon healing. Eccentric strengthening (controlled lowering exercises) is especially effective.
4. Bracing
A counterforce brace worn around the forearm can reduce strain on the tendon during activities.
5. ImageGuided Injections
If symptoms persist, injections may help.
Cortisone Injection
Pros:Provides short-term relief by reducing inflammation.
Cons: Effects may wear off with time, with repeated cortisone injections potentially weakening the tendon.
PlateletRich Plasma (PRP) Injection
PRP uses your own blood, processed to concentrate growth factors that stimulate tendon repair.
Benefits of PRP:
Research highlights:
6. Surgery (Rare)
Surgery is only considered when symptoms persist despite prolonged conservative treatment.
When to Seek Care
You should seek medical evaluation if:
Early treatment helps prevent chronic pain and tendon degeneration.
FAQs
Is tennis elbow caused by playing tennis?
Not usually. Many people develop it from typing, lifting, carpentry, or repetitive hand use.
Can tennis elbow heal on its own?
Yes, many cases improve with rest and exercises, but some require additional treatment like PRP.
Is PRP better than cortisone?
Evidence shows PRP provides longer-lasting relief and avoids tendon weakening associated
with cortisone.
Should I stop using my arm?
You don’t need complete rest, but you should avoid activities that worsen pain.
Do braces help?
Yes. A counterforce brace can reduce strain on the tendon during movement.
Will I need surgery?
Most patients recover without surgery. It is only considered after months of unsuccessful conservative care.
Overview
Achilles tendinitis is a condition where the large tendon at the back of your ankle ( the Achilles tendon) becomes irritated or inflamed. This tendon connects your calf muscles to your heel bone and helps you walk, run, and jump.
The condition often develops from overuse, tight calf muscles, sudden increases in activity, or repetitive strain from sports. Achilles tendinitis can occur in anyone but is more common in active adults.
Symptoms
Common symptoms of Achilles tendinitis include:
Symptoms often begin gradually but may worsen if the tendon continues to be strained.
Diagnosis
Medical History & Examination
Your clinician will examine the heel and tendon, checking for:
Imaging (if needed)
Although not always required, imaging can help confirm the diagnosis:
Treatment Options
Most cases of Achilles tendinitis improve with nonsurgical treatment.
1. Activity Modification
2. Medications
Anti-inflammatory medications (NSAIDs) may help reduce pain in the early stages when inflammation is present.
3. Physiotherapy
4. Orthotics & Footwear
5. Injections
Cortisone injections
Not typically recommended for Achilles tendinitis because they may increase the risk of tendon rupture.
PlateletRich Plasma (PRP) injections
PRP can cure the achilles tendinitis
7. Surgery
Reserved for:
When to Seek Care
You should seek medical attention if you experience:
Early assessment and treatment improve recovery and reduce the risk of chronic tendon damage.
FAQs
Is Achilles tendinitis the same as a tendon tear?
No. Tendinitis is irritation and inflammation; a tear involves actual tendon damage. Untreated tendinitis, however, can progress toward degeneration or tearing.
Can Achilles tendinitis heal on its own?
Many cases improve with rest, stretching, and proper treatment, though recovery may take several weeks to months.
Should I stop exercising?
You don’t need to stop all activity—switch to lowimpact exercise and avoid activities that trigger pain.
Will I need surgery?
Most patients improve without surgery. Surgery is only considered when all conservative treatments fail.
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