Nerve Hydrodissection: A Minimally Invasive Treatment for Trapped Nerves

Nerve entrapment from scar tissue, adhesions, or direct trauma causes burning pain in the area innervated by the nerve. Nerve hydrodissection offers an innovative way to treat these entrapments without surgery. Under ultrasound guidance, we inject fluid around the nerve to free it from scar tissue or other structures that are compressing it. The procedure is minimally invasive, takes around 30 minutes, and involves minimal downtime. 

Dr Masci performs nerve hydrodissection at his London clinics. He also teaches this advanced technique to doctors across the UK and Europe through his advanced ultrasound-guided injection course with SonoSkills. Few UK clinicians offer this procedure; fewer still teach it.

What does nerve-related pain feel like?

Pressure on a peripheral nerve produces a recognisable pattern:

• Deep-seated soreness or electric-shock pain in the area the nerve supplies
• Pins and needles or numbness, often alongside the pain
• Hot or cold sensations in the affected region, sometimes with bluish skin discolouration

Symptoms often worsen with specific positions or activities that stretch or compress the nerve. If this pattern sounds familiar, the body map at the bottom of this page links to every major nerve entrapment we treat.

What is a hydrodissection injection?

A hydrodissection injection uses fluid to separate a trapped nerve from the tissues around it — scar tissue, fascia, or muscle. The fluid mixture varies by case: saline, local anaesthetic, 5% dextrose, and sometimes cortisone or PRP. The injected fluid physically frees the nerve and reduces the inflammation irritating it.

Accuracy decides everything. The needle must travel around the nerve without touching it, and the fluid must dissect the entire circumference of the nerve free from the surrounding soft tissue. This is why we perform every hydrodissection injection under ultrasound guidance — it makes the procedure safe, precise, and effective.

What is the evidence for nerve hydrodissection? 

The strongest evidence comes from carpal tunnel syndrome, the most common nerve entrapment. Randomised trials show that ultrasound-guided hydrodissection with 5% dextrose improves pain, symptoms, and nerve function compared with placebo injection. Evidence for other entrapments — cubital tunnel, lower-limb nerves, and hip and groin nerves — is growing, with consistent reports of meaningful relief and low complication rates.

Hydrodissection sits between conservative care and surgery. For patients who have failed activity modification, medication, and physiotherapy, it offers a genuine alternative before considering surgical release.

How does Dr Masci perform a nerve hydrodissection?

The procedure follows clear steps:

• We position you so that the target nerve is clearly visible on ultrasound.

• We clean and sterilise the skin over the injection site.

• Dr Masci inserts a fine needle under ultrasound guidance into the area around the nerve.

• He injects the fluid mixture in a controlled way, watching it separate the nerve from the scar tissue and adhesions around its full circumference.

The appointment takes about 30 minutes. Dr Masci uses local anaesthetic, so most patients find the procedure comfortable. He offers nerve hydrodissection as a one-stop visit: consultation, diagnostic ultrasound to confirm the entrapment, and the procedure in a single appointment where appropriate.

Nerve hydrodissection side effects

The procedure is generally safe. Possible side effects include:

• Temporary discomfort: mild soreness or bruising at the injection site for 2–3 days

• Swelling: a small amount of localised swelling, settling within a few days

• Nerve irritation: transient tingling for a few days; it rarely lasts beyond a week.

• Infection: rare (around 1 in 10,000), minimised by sterile technique

Nerve hydrodissection recovery

Recovery is straightforward. Rest for a few days after the procedure. Most patients return to light activity after three days and full activity within a week. If you experience a flare or irritation, delay your return until symptoms settle.

How much does a nerve hydrodissection cost?

Dr Masci performs nerve hydrodissection at his London clinics, with the most cost-effective self-pay option at Chelsea. Prices at other clinic locations are higher. Review his one-stop injection fees here, or contact his team for a quote for your specific nerve entrapment — fees vary based on the complexity and location of the nerve.

Frequently asked questions about hydrodissection

Should a hydrodissection injection be done with ultrasound guidance?

Yes, always. The needle must pass millimetres from the nerve, and the fluid must surround it. Ultrasound guidance makes this possible, improves accuracy, and increases the duration of effect. Never have this procedure performed blindly.

Is nerve hydrodissection painful?

The procedure causes little pain in practice. We use a local anaesthetic, and the ultrasound-guided technique avoids contact with the nerve itself. Some patients feel pressure or brief tingling as the fluid spreads.

How long does a hydrodissection injection last?

Duration varies with the severity of the entrapment. We expect the benefit to last at least three months, and many patients improve for considerably longer. Some need a repeat injection; others gain lasting relief from a single procedure.

Can a hydrodissection injection be repeated?

Yes. If the first injection helped but the benefit faded, we can repeat the procedure. A partial response often guides us to adjust the fluid mixture — for example, adding cortisone or PRP.

Which nerve entrapments respond to hydrodissection?

We use nerve hydrodissection for:

• Carpal tunnel syndrome
• Cubital tunnel syndrome
• Tarsal tunnel syndrome
• Groin nerve pain
• Meralgia paresthetica
• Sural nerve entrapment
• Saphenous nerve entrapment

What other treatments do we combine with a hydrodissection?

Hydrodissection works best as part of a plan. We combine it with activity modification, nerve medications such as amitriptyline or duloxetine, and physiotherapy with neural stretching and strengthening exercises.

Can hydrodissection help me avoid surgery?

Often, yes. For entrapments such as carpal tunnel syndrome, hydrodissection offers a genuine middle step between conservative care and surgical release. Some patients still need surgery, but many achieve lasting relief without it.

Final word from Sport Doctor London about nerve hydrodissection

Ultrasound-guided nerve hydrodissection offers a safe, minimally invasive solution for nerve entrapment pain. By freeing the nerve from adhesions and compression, the procedure provides lasting relief with minimal downtime — and it may help you avoid surgery.

Dr Masci performs nerve hydrodissection in London and teaches the technique internationally. For further information, including costs, contact his team here or call +44 (0) 203 488 0350.

Click on the location of your symptoms to find your specific nerve entrapment.