Ultrasound-Guided Hydrodissection
Releasing a trapped nerve with fluid instead of a scalpel
Some pain does not come from a joint or a tendon - it comes from a nerve that has become trapped, compressed or stuck to the tissue around it. The result: burning, tingling, electric sensations, numbness, or pain that follows the path of the nerve.
Hydrodissection is a minimally invasive, ultrasound-guided procedure in which fluid is injected precisely around the nerve, gently separating it from the surrounding tissue and relieving the mechanical irritation.
No incision. No scar. A procedure measured in minutes - with the needle guided in real time by ultrasound.
What is nerve hydrodissection?
Nerves are meant to glide freely as we move. After injury, overuse, surgery or chronic inflammation, a nerve can become tethered - compressed by fascia, scar tissue or swollen neighboring structures. Every movement then pulls and irritates it.
In hydrodissection, the physician uses a fine needle, under continuous ultrasound visualization, to inject fluid (typically a dilute local anesthetic solution, sometimes with additional agents) into the plane around the nerve. The fluid does the work: it separates the nerve from the tissue compressing it and restores its ability to glide.
Which problems can it address?
In suitable cases, hydrodissection may be considered for:
- Carpal tunnel syndrome (median nerve at the wrist)
- Ulnar nerve irritation at the elbow - often alongside golfer's elbow
- Radial nerve entrapments near the elbow
- Nerve pain after surgery or injury, related to scar tissue
- Selected entrapments in the shoulder, hip, knee and ankle regions
- Persistent, localized nerve pain where imaging and examination point to a specific entrapped nerve
The essential precondition is a precise diagnosis: identifying the exact nerve, and the exact site where it is caught. That is what the clinical exam and diagnostic ultrasound are for.
What happens during the procedure?
- The region is scanned with ultrasound and the nerve is identified
- The skin is cleaned and numbed locally
- Under continuous ultrasound guidance, a fine needle is advanced to the plane beside the nerve
- Fluid is injected slowly; on the screen, the nerve can be seen separating from the surrounding tissue
- The needle is withdrawn - typically after only a few minutes
Most patients go home shortly afterwards and return to light normal activity the same day. Mild local soreness for a day or two is common; some feel a change in symptoms quickly, while for others improvement builds gradually over days to weeks.
Why choose this before considering surgery?
Surgical release remains the right answer for some severe entrapments. But for many patients, hydrodissection offers a rational earlier step:
- Minimally invasive - no incision, no scar, no recovery period to speak of
- Diagnostic value - the response to the procedure itself sharpens the diagnosis
- Repeatable when appropriate
- Leaves every future option open
At Team Clinic 360°, hydrodissection is performed by Dr. Lior Shem Tov, specialist in anesthesiology and pain medicine, as part of a plan coordinated by Dr. Natalie Siegel.
Nerve pain with a mechanical cause deserves a mechanical answer
If you have burning, tingling or electric pain that follows a nerve - and treatments so far have only masked it - an evaluation can determine whether an entrapped nerve is the cause, and whether hydrodissection can release it.
To schedule an evaluation for ultrasound-guided hydrodissection - contact us by phone or WhatsApp.
Frequently asked questions
Does hydrodissection hurt?
The skin is numbed first, and the injection is slow and controlled. Patients typically describe pressure or brief odd sensations along the nerve rather than sharp pain.
How is this different from a cortisone injection?
A cortisone injection treats inflammation chemically. Hydrodissection treats compression mechanically - the fluid physically separates the nerve from what is pressing on it. In some cases the two approaches are combined.
How many treatments are needed?
Some patients respond well to a single procedure; others benefit from a short series. The plan depends on the nerve involved, the severity of the entrapment and your response.
Can it replace carpal tunnel surgery?
In milder and moderate cases it can be an effective alternative or a way to defer surgery; in severe cases with significant weakness or muscle loss, surgery may still be the right choice. This is exactly what the evaluation clarifies.
Is it safe?
Performed under continuous ultrasound guidance by an experienced physician, hydrodissection is considered a low-risk procedure. The visible needle path and real-time control are precisely what makes it safe.
Medical sources for further reading
The information on this page is intended as general background and does not replace personal medical advice.
The information on this page is general in nature and does not replace a personal medical diagnosis, consultation or treatment. Any treatment is tailored only after a medical evaluation, at the physician's discretion.