Nerve entrapment from scar tissue, adhesions, or direct trauma causes burning pain in the area supplied by the nerve. Nerve hydrodissection injection is an innovative technique used to treat nerve entrapments. Guided by ultrasound, this procedure involves injecting fluid around a nerve to free it from surrounding scar tissue or compressed tissues. Nerve hydrodissection is an increasingly popular treatment due to its effectiveness and minimal downtime.

What are the characteristics of nerve-related pain?

Generally, pressure on a peripheral nerve causes the following symptoms:

  • Deep-seated soreness or electric shock sensation supplied by the nerve
  • Occasionally, pins and needles and numbness can occur with pain
  • A sensation of cold or hot can be felt in the affected region, and the colour of the skin may appear bluish

Nerve hydodissection procedure

Nerve hydrodissection uses a combination of fluid (saline, anaesthetic, dextrose or other agents such as cortisone or PRP) injected around a nerve to separate it from surrounding tissues such as scar tissue, muscles, or fascia. The goal is to relieve pain and reduce inflammation.

Using ultrasound to place the needle in the right spot accurately is critical. This makes the procedure safe and effective while minimising risks.

Step-by-step procedure

picture showing nerve hydrodissection
  • The patient is positioned so that the target is easily visualised on ultrasound.
  • The skin over the injection site is cleaned and sterilised.
  • We insert a fine needle under ultrasound to the area around the nerve.
  • A fluid mixture is injected close to the nerve, separating it from other structures, such as scar tissue and adhesions. The key is to ensure we dissect the entire nerve circumference away from the soft tissue surrounding it.

The procedure takes about 30 minutes to perform.

Nerve hydrodissection side effects

While nerve hydrodissection is generally safe, some patients may experience side effects, including:

  • Temporary Discomfort: Mild soreness or bruising at the injection site lasts 2-3 days.
  • Swelling: A small amount of localised swelling is expected and usually resolves within a few days.
  • Nerve Irritation: Patients can experience transient nerve irritation or tingling lasting a few days. The irritation rarely lasts longer than a week.
  • Infection: An infrequent complication, minimised with sterile techniques. The rate of infection is 1/10000.

Nerve hydrodissection recovery 

Ususally, recovery is straightforward. We suggest the patient rest for a few days after the procedure. Most individuals can return to light activities after three days and full activities within a week. This recovery may need to be delayed if the patient experiences side effects.

Frequently asked questions about hydrodissection: 

Should a hydrodissection injection be done with ultrasound guidance?

Yes. Ultrasound guidance improves accuracy and increases the duration of effect.

Is nerve hydrodissection painful? 

Usually yes. However, most practitioners use a small dose of local anaesthetic, so the procedure is often pain-free.

How long does a hydrodissection injection last? 

The duration of the effect varies according to the severity of nerve entrapment. However, we expect the positive impact to last at least three months.

What nerve entrapments will benefit from a nerve hydrodissection? 

We think the following nerve entrapments will respond to a hydrodissection:

What other treatments do we use with a hydrodissection? 

Other treatments include modifying activity, nerve medications such as amitriptyline or duloxetine, and physical therapy, which comprises neural stretching and strengthening exercises.

Final word from Sportdoctorlondon about Hydrodissection Injection 

Ultrasound-guided nerve hydrodissection offers a safe solution for nerve pain from entrapment syndromes. This procedure provides lasting relief by freeing the nerve from adhesions or compression. If you’re experiencing nerve-related pain, consult a sports doctor to determine whether nerve hydrodissection is the proper treatment for you.