Knee Pain

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Ultrasound-guided Nerve/Myofascial Plane Hydrodissection

Nerve hydrodissection is a safe method of relieving nerve entrapment by injecting regenerative substances around a nerve. This procedure can only be done safely under ultrasound visualization in order to pin-point choke point areas and also to avoid damage to surrounding structures, i.e. blood/lymphatic vessels or going into nerve fibers themselves. The injected fluid is meant to create a “halo” around the nerve to cushion it. This creation of space via injected fluid relieves the pressure off the nerve from the surrounding muscles and separates the nerve from restrictive adhesions or “webs” made by tissue, fascia (connective tissue lining of muscles), post-surgical scar tissue or adjacent structures like bony spurs, etc. Such adhesions restrict the nerve’s mobility and function thereby causing irritation, enlargement and chronic pain over time.

Patients will usually seek out this treatment after having exhausted standards of care with respect to pain management, including acupuncture, physiotherapy and/or surgical interventions.

Ultrasound-guided Nerve Hydrodissection

Conditions treated:

  • Chronic / non-responsive lower back, shoulder, joint or musculoskeletal pain
  • Chronic post-surgical pain
  • Nerve impingements due to anatomical defects, trauma or surgery
  • Thoracic outlet syndrome
  • Non-responsive carpal/tarsal tunnel syndromes
  • Cancer pain management


The resolution obtained from ultrasound has significant advantages over magnetic resonance (MRI) or X-ray imaging in the evaluation of peripheral nerves, including but not limited to:

  • Superior or equal specificity and enhanced soft-tissue resolution and specificity vs. MRI
  • Ability to see myofascial adhesions, soft tissue abnormalities and joint architecture
  • Cost-effective over more expensive imaging approaches of CT or MRI
    Real-time and dynamic imaging (MRI and CT are static and cannot accentuate many pathologies)
  • Defects and impingements can be seen during physical exam/motion palpation
  • Clinically abnormal findings may be immediately compared with the contralateral side
  • Targeted injections often have no long-lasting side effects or residual scarring of tissue
  • Avoid invasive procedures/surgery

The potential for nerve hydrodissections to get patients out of pain cannot be understated. Quality of life is often dramatically and immediately improved as well as the patient avoiding the high costs to more invasive interventions or surgeries which generally have higher risks and complications.

Cancer Pain Management

Targeted ultrasound-guided nerve hydrodissections may provide safe and effective pain management strategies for mitigating the side effects of standard cancer treatments using chemo/radiation therapy. The concept of bathing and protecting vital structures from heat injuries due to radiation/ablation is also well-acknowledged in the scientific literature. Long courses of chemotherapy, surgical resections and/or radiation often create serious injury to peripheral nerves or scarring causing numbness, tingling or impaired motor function/range of motion. By injecting regenerative solutions around damaged or inflamed nerves and opening myofascial planes we can improve swelling and reduce the long-term pain created by scar-tissue adhesions.

Many other common side effects post-surgery and chemo/radiation therapy may also be addressed by targeted hydrodissection including:

  • lymphedema
  • pain
  • numbness or weakness related to tumor surgery or radiation
  • abdominal wall/chest pain syndromes due to excess scar tissue adhesions
    and others

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Mon: 10am-12pm & 1pm-4pm
Tues-Thurs: 9am-12pm & 1pm-4pm
Friday: closed

1700 California Street, Suite 520
San Francisco, CA 94109

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