David and Val,
I have been thru this exercise, so here are my opinions for what they are worth.
First, there is a lot of info online. One reference which helped me with a step wise approach was:
http://www.veradoclub.com/index.php?topic=137.0
We have a CD 22 with a 2007 90hp Etec. While a 15" prop put us in the acceptable rpm window with a light load [2 people, 20 gal fuel, no water, gear], it was on the low side. We usually carry [over half the time] a load more like 4-6 people and more gear [800-1100 lbs], so we decreased pitch to 11". Now we can turn about 5400 rpm lightly loaded and stay in the 45-5500 range loaded. Yes, speed dropped a few mph, but I think it is more important to work the engine comfortably than to milk a bit more speed out of it. We run at about 4000-4200 usually which yields about 16- 18 mph. This has been our experience, and comports with our priorities for our circumstances. Ours is only an example of the exercise and of our thinking.
What about you? To my mind, 4200 is low and you are lugging your motor, which will shorten its life even if run at less than full throttle. Your acceptable rpm range is 4500-5500. The idea of about 200 rpm per inch of pitch seemed to hold for me and is widely quoted. If you cited your usual load [2 people and gear] for 4200 rpm, you might consider a pitch of 13" which would probably get you around 5000 rpm WOT. A Solas prop for Etecs is about $100 US. If your rpms are then too high [doubt it] you can get the prop cupped to decrease rpm/increase load on prop. If your marina or friends can help with loaner props, that would be nice. If you like to run stainless, maybe try a cheapy aluminum and when you get it right, go stainless and keep the 17" and the cheapy for spares. You can figure all of that out!
DavidM had good observations on 2-stroke motorcycles. While my experience with 2-stroke motorcycles is limited to a 50-something Zundapp, my experience with true 2- stroke outboards is that failing rings resulting in increased blow by compromise idle first and foremost. If it won't idle, and it is tuned, check compression. Etecs are a different breed, tho, because they have direct injection, and do not depend on crankcase pressure for fuel delivery. They do depend on crankcase pressure for air intake. I doubt that your motor is worn out. If you do prop down in pitch and it does not help, checking compression is pretty straightforward - again, I doubt that you will need to go there.
I hope this helps!
andy