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Nerve Hydro-dissection

Nerve hydro-dissection, though sounding somewhat frightening, is actually a very safe and relatively easy treatment for the patient to undergo.  When nerves, for example the median nerve in carpal tunnel, become entrapped by structures around them the problems which result can be many and varied but usually neuropathic pain is at the top of the list.  Hypoesthesia (or numbness) and paresthesias and other radicular symptoms are common.  Depending on the duration of the damage to the nerve often patients are faced with the decision of having to undergo surgery or cortisone injections as last measures for relief.


Nerve hydro-dissection uses the jet of an injected isotonic fluid from the needle tip to separate the nerve from the structure within which is is being trapped. For example in the case of carpal tunnel the median nerve of the forearm and wrist becomes trapped by the flexor retinaculum at the wrist.   Under direct visualization in real time using ultrasonographic guidance, to avoid damaging the nerves and blood vessels a jet of isotonic fluid is used to free the nerve from inside the retinaculum.   Most often relief is experienced immediately and the relief is longer lasting than with cortisone injections and does not need endless treatments for a final resolution of the problem.  Please refer to this study done comparing Nerve hydro-dissection to cortisone injection and surgical release.


Ultrasound-Guided Percutaneous Injection, Hydrodissection, and Fenestration for Carpal Tunnel Syndrome:
Description of a New Technique

Daniel G. Malone,MD   Thomas B. Clark, DC, RVT     Nathan Wei, MD

Vol.10, No.3 , 2010 •The Journal of Applied Research