Gain, Not Pain
“I needed relief from the pain to keep me going,” says McBrearty. “I wouldn’t be doing any of the things I love without that.”
The things the 76-year-old Palm Springs resident loves include volunteering weekly at a food bank at the Cathedral City Senior Center, reading with kindergarten students in the “Read With Me” program at Agua Caliente Elementary School in Cathedral City and a much-loved job once or twice a week as an usher at Agua Caliente Casino Rancho Mirage, all of which keep her on her feet.
Three times weekly, she takes part in water aerobics, which temporarily gives her knees -troubled by “bone-on-bone arthritis” - a chance to rest and recuperate.
This is why McBrearty appreciates the care she receives from Eisenhower Desert Orthopedic Center and Cesar Abdul-Massih, MD, a non-surgical orthopedist and sports medicine specialist.
“I do everything I can to optimize non-surgical treatment measures,” he says, “but, at the same time, I appropriately guide patients to surgery when I think it’s in their best interest.”
A multi-faceted tool kit
For osteoarthritis and bursitis, his toolkit of remedies includes physical therapy, exercise, topical treatments, oral medications and various injectables, including cortisone for pain and inflammation, hyaluronic acid as a cushion for cartilage loss, and regenerative medicines like platelet-rich plasma from a patient’s own blood.
“We don’t have a magic trick to reverse or stop arthritis but there are lots of things we can do to manage it and help your overall health,” Dr. Abdul-Massih says.
Dr. Abdul-Massih earned his Master of Science in Physiology and completed a residency in emergency medicine. Then, he chose an elective in sports medicine at Henry Ford Health in Detroit and “fell in love,” he says. “I found the specialty that brought together all my interests.”
He completed a fellowship in Sports Medicine at Eisenhower Health before joining EDOC in 2023.
Board Certified in Internal Medicine and Sports Medicine, his patients range from high school and college athletes to professional tennis players, golfers and “people who just want to be able to keep doing the things they enjoy,” he says.
McBrearty’s goal is clear: “I want to avoid surgery on my knees as long as possible.”
She was thrilled to learn Dr. Abdul-Massih offers injections with ultrasound visual guidance. Standard procedure is a “landmark-guided injection,” where a physician uses anatomic landmarks of the patient’s knee, shoulder or hip, then guides the needle accordingly. Aided by ultrasound images, Dr. Abdul-Massih visualizes the patient’s anatomy in real time and pinpoints the most-accurate approach and target for a guided injection.
“With arthritis, you have joint space narrowing and may develop bone spurs, and that makes it more difficult to accurately get the needle into the joint space,” Dr. Abdul-Massih says.
Image guidance allows an orthopedist to know with greater certainty if a patient gets lasting or only short-lived relief from an injection, he adds.
“Then, you can more accurately say whether the patient did or did not respond to the guided injection. Based on those results, I can then advise the patient on the option of further nonsurgical or surgical treatment,” he says.
Locating the “main pain” 
Every six months, McBrearty receives a cortisone injection in both knees and a hyaluronic acid injection (nicknamed “the gel shot” for its consistency).
“My relief kicks in right away,” she says.
That’s good news, but McBrearty also has severe arthritis in her shoulders - particularly her right shoulder - to the point she has difficulty lifting her arm.
When cortisone injections failed, Dr. Abdul-Massih consulted with an EDOC surgeon, then outlined the options for McBrearty.
“I appreciate him going the extra mile to make his patients comfortable,” says McBrearty, who is scheduling her shoulder surgery.
Ensuring that patients are educated about their condition and options is a top priority for Dr. Abdul-Massih.
“When you’re better informed, you’re able to make better decisions for yourself,” he says.
Equally important, he says, patients who participate in their treatment plans - whether you’re a 14-year-old quarterback with a mild concussion or a 76-year-old water aerobics devotee - typically have better outcomes.
He doesn’t believe in a “no pain, no gain” philosophy.
“You’re not supposed to push past or through pain,” he says, “because pain’s your body telling you, ‘Hey, I don’t like that. That hurts.’”
“My whole goal is to get patients back to doing the things they love as much as possible,” he adds, “and also improving their quality of life.”
To learn more about Eisenhower Desert Orthopedic Center services,
visit EisenhowerHealth.org/EDOC, or call 760.773.4545.