What Is Ultrasound-Guided Nerve Hydrodissection?
Nerve hydrodissection using ultrasound guidance is a safe method of relieving nerve entrapment by injecting regenerative substances (e.g. PRP/platelet–rich plasma, diluted dextrose, cell-derived growth factors) around a nerve or to open up myofascial plane adhesions/restrictions. 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.
- 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
How Long Does It Take a Hydrodissection to work
The pain relief and increased range of motion that occurs after a hydrodissection can often be instant. Patients often report better range of motion, stability, and less pain after the procedure. There is a momentary sense of fullness in the area due to the product volume injected which dissipates in a few days.
And How Long Do the Effects Last?
Depending on the type of regenerative product injected (e.g. PRP vs concentrated growth factors vs. Dextrose solution), amount of physical/pain management rehab post-op, appropriate taping of the area and severity of the condition, effects of a hydrodissection can last for months upwards of years.
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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:
- peripheral nerve damage due to radiation/surgery causing numbness, tingling, weakness
- abdominal wall/chest pain syndromes due to excess scar tissue adhesions