Direct Answer: Nerve hydrodissection is an ultrasound-guided injection technique that places fluid around a peripheral nerve to separate it from surrounding tissue when compression, irritation, or tethering contributes to symptoms. The injectate may include dextrose in sterile water and, in selected cases, PRP. The first step is identifying which nerve is involved and why.
What Is Nerve Hydrodissection?
Peripheral nerves normally glide through surrounding tissues as the body moves. Scar tissue, fascial restriction, inflammation, repetitive loading, or anatomic compression can interfere with that movement. Hydrodissection uses live ultrasound to guide a needle into the tissue plane around the nerve and introduce fluid to separate the nerve from adjacent structures.
Why Ultrasound Guidance Matters
Peripheral nerves can be small and can lie close to blood vessels and other important structures. Live ultrasound helps identify the nerve and surrounding anatomy, plan the needle path, and confirm placement of the injectate in real time.
When Is It Considered?
Hydrodissection may be considered for selected peripheral nerve irritation or entrapment problems involving areas such as the wrist, elbow, forearm, hip, thigh, knee, ankle, or foot. Symptoms such as numbness or burning can also originate in the spine or other structures, so an accurate diagnosis comes first.
What Is Injected?
Dextrose in sterile water is commonly used for perineural hydrodissection. Depending on the diagnosis, an autologous orthobiologic such as PRP may also be considered. The treatment is individualized rather than a one-size-fits-all injection.
Who May Be a Candidate?
A patient may be considered when symptoms and examination findings suggest a peripheral nerve is compressed, irritated, or tethered and conservative treatment has not provided an adequate solution. Severe or progressive neurologic deficits or conditions requiring surgical decompression need appropriate specialist evaluation rather than repeated injections.
Dr. Tortland's Perspective
My approach starts with the diagnosis, not the injection. I want to know which structure is generating the symptoms and why before deciding whether hydrodissection is appropriate. I am dual board-certified in Sports Medicine & OMM and Regenerative Medicine, and I was the first physician in the world board certified in Regenerative Medicine in 2015. I have practiced orthobiologic medicine since 2007.
My philosophy is Validate – Investigate – Regenerate. For the right patient, hydrodissection can be one part of a larger treatment plan rather than simply a way to mask symptoms.
Considering nerve hydrodissection? Start with Hydrodissection for Dr. Tortland’s patient-facing treatment page.