Nerve Hydrodissection

Nerve hydrodissection is a non-surgical injection technique that can treat nerve entrapments, nerve injuries such as neuromas, or generalized neurogenic inflammation. Chronic nerve entrapment or neurogenic inflammation can cause pain, numbness, tingling, muscle weakness, and muscle atrophy. Nerve hydrodissection uses different injectates (most commonly 5% dextrose, platelet-rich plasma, bone marrow concentrate, or microfragmented adipose tissue) to mechanically separate the nerve from the surrounding tissue, fascia, or another adjacent structure. This means that nerve hydrodissection can be helpful in two different ways. The first is that by reducing compression on the nerve with the injected fluid, nerve hydrodissection can help restore the nerve to a healthier state by helping the small blood vessels supplying oxygen and nutrients and removing waste products to function better. The second is that the injectate used has biological activities in addition to the mechanical aspect, such as reducing inflammation. Nerve hydrodissection is always performed under ultrasound guidance, as this is the only way to ensure we are properly separating the nerve from the surrounding fascia. Additionally, we use ultrasound to evaluate where the fluid is not flowing, as this helps to show us where the worst adhesions are found around the nerve.