About Nerve Hydrodissection
Nerves need to slide as joints move. When a nerve becomes stuck to nearby tissue, or is squeezed by a tight tunnel, it can cause pain, numbness, tingling, or burning. This is called nerve entrapment.
Hydrodissection places fluid, often saline with or without other medicines such as dextrose or a small amount of steroid, around the nerve. Under ultrasound, your physician watches the fluid gently lift the nerve away from the surrounding tissue, freeing it to move.
Dr. Gruner and Dr. Chen use this technique for many nerves, including in carpal tunnel syndrome, cubital tunnel syndrome, and entrapments in the leg and foot. It can be a middle step between conservative care and a release procedure.
What happens during treatment
- 1.
Your physician examines you and uses ultrasound, and sometimes nerve testing, to find where the nerve is trapped.
- 2.
The skin is cleaned and numbed.
- 3.
Under live ultrasound, a needle is guided next to the nerve, and fluid is injected to separate the nerve from surrounding tissue.
- 4.
You rest briefly and go home the same day with guidance on activity and nerve-gliding exercises.
Who may be a good candidate
- People with numbness, tingling, or burning from an entrapped nerve, such as at the wrist, elbow, or ankle.
- People with mild to moderate carpal tunnel syndrome who want to try a less invasive step before a release.
- People with nerve pain after an injury or surgery where scar tissue may be involved.
- Patients without significant muscle weakness from the nerve problem.
Recovery
Most people return to normal activity the same day or the next. The area may be sore for a day or two, and numbness from the anesthetic wears off within hours. Nerve-gliding exercises help maintain the nerve's movement, and some people need more than one session.
Risks and limits
Risks include soreness, bruising, bleeding, infection, and a temporary increase in nerve symptoms. Direct nerve injury is rare and is guarded against by ultrasound guidance. If steroid is used, it can briefly raise blood sugar. Hydrodissection may not be enough when nerve testing shows severe compression or muscle weakness, and in that case a release procedure or surgical opinion is often the better step. Sudden weakness should be evaluated promptly.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about Nerve Hydrodissection
- What fluid is used for nerve hydrodissection?
- The main fluid is usually saline, sometimes combined with a numbing medicine, dextrose, or a small dose of steroid. Your physician chooses the mix based on the nerve and your health history.
- Will I need more than one treatment?
- Some people improve after one session, while others benefit from a short series. We reassess after each treatment before deciding on another.
- Is hydrodissection an alternative to carpal tunnel release?
- For mild to moderate carpal tunnel syndrome, hydrodissection can be a reasonable step before a release. When compression is severe or there is muscle weakness, a release is usually the better option.