Review Article
Nerve Hydrodissection for Pain Management: A Scoping Review
Mary Monica Bernardo-Bueno11.2.3 , Consuelo Gonzalez-Suarez2.4 , Steve Milanese5 , Ephraim DV Gambito2.6.7

1University of Santo Tomas Graduate School, Manila, Philippines

2Department of Physical Medicine and Rehabilitation, Our Lady of Lourdes Hospital, Manila, Philippines

3Department of Physical Medicine and Rehabilitation, East Avenue Medical Center, Quezon City, Philippines

4Research Center for Health Science, University of Santo Tomas, Manila, Philippines

5Allied Health and Human Performance, University of South Australia, Adelaide SA, Australia

6Department of Physical Medicine and Rehabilitation, St. Luke’s Medical Center, Quezon City, Philippines

7Department of Rehabilitation Medicine, Salve Regina General Hospital, Pasig, Philippines



Hydrodissection is a minimally-invasive procedure that involves injecting fluid into anatomic spaces to
facilitate dissection and adhesiolysis during surgery as proposed by Graesser et al. in 2022. In the past decade,
it has been applied to the management of nerve entrapments by injecting fluid around the nerve to create space
and separate them from surrounding structures. Injectates used are either saline, corticosteroids, anesthetic,
dextrose water, platelet-rich plasma, or combinations of these injectates. This study undertakes a scoping
review of the available evidence on nerve hydrodissection to determine the extent of research done and report
on information particular to this procedure. PubMed, EBSCOhost, Google Scholar, and ScienceDirect were
searched, and a total of 70 articles were included in this study. Due to the lack of standardization of the factors
such as injectate choice and volume, firm recommendations for the effectiveness of nerve hydrodissection are
difficult to develop. Further research, especially those that aim to standardize aspects of nerve hydrodissection,
is needed.


hydrodissection, nerve hydrodissection, pain, scoping review


Hydrodissection is a minimally invasive procedure that involves injecting fluid into anatomic spaces to facilitate dissection and adhesiolysis during surgery [1]. In the past decade, it has been applied to the management of nerve entrapments by injecting fluid around the nerve to create space and separate them from surrounding structures. Injectates used are either saline, corticosteroids, anesthetic, dextrose water, platelet-rich plasma (PRP), or combinations of these injectates [2,3]. The most studied indication for nerve hydrodissection is median nerve entrapment at the wrist and it has, in fact, been included as one of the management options for carpal tunnel syndrome in Harrison’s Principles of Internal Medicine [2]. Nerve hydrodissection has also been applied to other neuropathies; however, most are case reports and narrative reviews.

The present study undertakes a scoping review with the following objectives: (1) identify the available evidence on nerve hydrodissection, (2) clarify key concepts such as definition and mechanism of action, (3) report on available information on the injection techniques, injectate choices, outcomes and outcome measures used, possible adverse effects and potential application of the procedure to knee osteoarthritis pain management, and (4) identify the gap in the literature.


The protocol for this review was registered in the Open Science Framework (Registration DOI: The Joanna Briggs Institute (JBI) framework for the conduction and preparation of scoping reviews [4] was used as a guide in the conduct of this review, and reporting is in accordance with the PRISMA extension for scoping reviews [5].

Following the JBI recommended “PCC” pneumonic which corresponds to Population, Concept, and Context [4], inclusion in the review was guided by the following criteria: Population—studies that included patients with pain secondary to nerve entrapment or neuropathic pain; Concept—studies that evaluated the effect of nerve hydrodissection; Context—observational studies, randomized and nonrandomized clinical trials, reviews, qualitative studies, and case reports in English or with available English translations, published in the last 10 years (2011–2022). Unpublished work limited to conference proceedings and preprints were also considered. Encyclopedia entries and book chapters were excluded. The year 2011 was chosen because although hydrodissection has been around since the 1990s, the surge of studies on ultrasound-guided hydrodissection specifically applied to nerve entrapment occurred in the past decade [1,6].

Search Strategy

Medline/PubMed and EBSCOHost were initially searched for available articles within the field of study. Terms and words found in the abstracts and titles of articles were used for a more refined search strategy for MEDLINE, EBSCOhost, Google Scholar, and ScienceDirect. The search terms used are summarized in Table 1.

Table 1. Search Terms and Parameters Used for the Search Strategy

Study Selection

All identified potential citations were collated and uploaded into the data management software Covidence©. Two reviewers independently assessed titles and abstracts based on the inclusion criteria set. Full-text articles were retrieved and re-tested against the parameters for inclusion. Reference lists were examined for additional studies that were also reviewed for inclusion.

Data Charting and Synthesis

The method of data charting was guided by JBI recommendations [7] and adapted from the study of Rüeger et al. [8]. A data charting form was developed using Microsoft Excel and underwent pilot testing. A reviewer (MB) charted the data as follows: title, first author, year of publication, country of the first author or where the study was conducted (whichever is available), type of study, objective, intervention/term used, definition of intervention/hydrodissection, proposed mechanism of action, nerve hydrodissected/location of hydrodissection, indication, study population and sample size, comparator, injectate and frequency of injection, injection technique, outcome and outcome measure/s, follow-up, side-effects, or other key information. The completed charting form was reexamined by a second author (EG) to ensure the correctness of the extracted data. Disagreements were resolved through discussion.

Descriptive statistics were calculated to summarize the data. Frequencies and percentages were utilized to describe nominal data.


A total of 1,787 potentially relevant articles were obtained from databases and registries, and an additional 5 studies were discovered from searching the reference lists. After duplicates were removed, the titles and abstracts of 1,488 studies were screened against the inclusion criteria. Among the 1,347 articles that were excluded, 1,242 were not within the concept of the study and discussed topics beyond the scope of nerve hydrodissection. Eighty-three articles were not within the context and were a combination of table of contents, indexes, and book chapters. Nine articles were about hydrodissection but investigated surgical patients which are beyond the intended population of the study. Thirteen articles had erroneous links and were not retrievable.

A total of 121 articles were assessed for eligibility, and a final count of 70 studies were included in the scoping review. A summary of the article selection process is depicted in Figure 1.

The descriptive-analytical method [9] was used in analyzing the data gathered from the included studies. To fulfill the objectives of the study, the data gathered were categorized into the following themes: (1) general characteristics of the studies—which will include the year of publication, country of origin, types of studies/methodology, (2) nerve targets and indications, (3) terminology used, definition and mechanism of action, (4) injection technique, (5) injectate and needles used, (6) outcome and outcome measures, and (7) adverse effects.

Figure 1. PRISMA Flow Diagram—Study Selection Process

Figure 2. General Characteristics of Included Studies
This figure presents the general characteristics of the included studies. (A) Distribution of studies by year of publication, (B) distribution of stud-
ies based on country of origin, (C) distribution of studies based on types of study or methodology.

Figure 3. Nerve Targets and Indications
This figure presents the distribution of included studies based on (A) nerve targets cited, and (B) indications mentioned.

General Characteristics of Included Studies

In this study, 51% (36/70) of the included articles were published from 2011–2020 while 49% (34/70) were published in the last three years (Figure 2A).

The country with the highest number of included studies was Taiwan at 25/70 (36%), followed by the USA (27%), India (9%), HK China (4%), Indonesia (4%), and Turkey (3%). The remaining countries, namely, Australia, Belgium, China, Egypt, Ireland, Japan, Malaysia, Philippines, Poland, Slovenia, and Thailand, contributed one study each to the pool. However, one article, a poster presentation, did not provide information on its country or origin (Figure 2B).

The types of studies included were: 20 case reports (29%), 12 literature reviews (17%), 9 randomized controlled trials (13%), 9 retrospective studies (13%), 5 letters to the editor (7%), 4 posters (6%), 2 case series (3%), 2 technical image studies (3%), 2 video gallery papers (3%), 1 abstract (1%), 1 commentary (1%), 1 pilot study (1%), 1 prospective cohort (1%), and 1 systematic review (1%) (Figure 2C).

Nerve Targets and Indications

The most common nerve that underwent hydrodissection cited by the included studies was the median nerve at the wrist at 30%, followed by the peroneal nerve (10%), ulnar nerve (9%), radial nerve (9%), lateral femoral cutaneous nerve (7%), saphenous nerve (7%), sciatic nerve (4%), dorsal scapular nerve (3%), superior cluneal nerve (2%), and sural nerve (2%). The rest of the nerve targets were each cited once: anterior interosseous nerve, Baxter’s nerve, cervical plexus, femoral nerve, greater occipital nerve, ilioinguinal nerve, iliohypogastric nerve, lateral antebrachial cutaneous nerve, posterior tibial nerve, posterior interosseous nerve, pudendal nerve, spinal accessory nerve, and suprascapular nerve (Figure 3A).

The most frequently cited indication was carpal tunnel syndrome (28%) followed by cubital tunnel syndrome (8%), peroneal nerve entrapment (7%), saphenous nerve entrapment (7%), meralgia paresthetica (7%), superficial radial nerve entrapment (4%), radial nerve palsy (4%), dorsal scapular nerve entrapment (3%), sciatica (2%), sural nerve entrapment (2%), and superior cluneal nerve entrapment (2%). Other indications mentioned were: median nerve entrapment at the pronator tunnel, Baxter’s neuropathy secondary to plantar fasciitis, thoracic outlet syndrome, superficial cervical plexus entrapment after neck lymphoma, femoral nerve entrapment, cervicogenic headache, ilioinguinal nerve entrapment, iliohypogastric nerve entrapment, lateral antebrachial cutaneous nerve entrapment, posterior interosseous nerve entrapment, urologic chronic pelvic pain syndrome (UCPPS), spinal accessory nerve entrapment, suprascapular nerve impingement, symptomatic sural nerve neuroma, piriformis syndrome, sciatic nerve tethering s/p mid-hamstring tendon repair, ulnar nerve entrapment at Arcade of Struthers, complex regional pain syndrome, peroneal nerve entrapment in knee osteoarthritis, deep peroneal neuroma, median nerve entrapment secondary to electric shock and pronator teres syndrome (Figure 3B).

Terminology Used, Definition, and Mechanism of Action

The intervention under study was most commonly termed as “hydrodissection” (46%). Other terms used to pertain to the intervention were “nerve hydrodissection” (19%), “perineural hydrodissection” or “perineural neurolysis” (10%), “perineural injection therapy” (3%), “percutaneous hydrodissection” or “percutaneous neurolysis” (2%), “perineural dextrose injection” (2%). Other terms encountered were: “perineural deep injection”, “neural prolotherapy”, and “percutaneous hydrotherapy”.

Among the studies that included a definition of hydrodissection, the common theme is that it is an ultrasound-guided technique that involves high-pressure injection of fluid, either an anesthetic, saline, dextrose water, PRP, or combinations of these fluids, to dissect anatomic planes and tissue spaces. This technique is used to manage nerve entrapments as it separates nerves from the surrounding tissue, fascia, or adjacent structures.

Two common mechanisms of action emerged from the studies reviewed: the mechanical release and decompression of the entrapped nerve, and the pharmacologic effect or the effect of the injectate used. Relief of pressure on the neurovascular structures decreases nerve hypersensitivity and creates space to limit adhesions, increase blood flow, and remobilize the nerve which secondarily decreases the neurogenic inflammation, improves nerve conduction, and prevents the onset and/or progression of ischemic damage to the nerve. The pharmacologic effect, on the other hand, depends on the injectate used. Anesthetics work to decrease pain and steroids are used to decrease inflammation but the effect of 5% dextrose water (D5W) is less understood. Studies that did discuss the proposed effect of D5W presented that chronic neuropathic pain may signify glycopenia around the nerve and injecting D5W may correct this and consequently reduce neuropathic pain. Another proposed mechanism of D5W is the decrease of neurogenic inflammation by inhibiting transient receptor potential vanilloid receptor-1 (TRPV-1) that can be found on peripheral nerves.

Injection Technique

There was great variation with regard to the injection technique utilized by the studies included due to the different areas and nerve targets presented; however, the following techniques were common to them:

.The choice of ultrasound machine and probe was based on the type most appropriate for the structure and depth of the nerve to be injected and the availability of the probe.

.The procedure starts with basic scanning of the involved structures to identify the site of entrapment, plan the injection course and visualize structural abnormalities and anatomical variations that may affect the procedure.

.Aseptic preparation is done prior to injection.

.The total injectate is divided into different locations around the area of entrapment (e.g., upper part of the nerve, then the lower part of the nerve) to ensure complete hydrodissection and release of the entrapment.

.Hydrodissection is done in the short- and long-axis views.

.The injection is done gradually and the operator maintains continuous visualization of the needle or the needle tip as it dissects the structure/s to be separated.

.Participants were monitored for 30 minutes after injection for possible side effects.

.After injection, the operator scans the injected areas to confirm delivery of injectate throughout the entrapment site.

There was not a common practice on the use of local anesthetic prior to hydrodissection. Of the 9 studies that mentioned local anesthetic, 7 [10-16] mentioned injecting 1%–2% lidocaine 1% lidocaine to the area, while two [17,18] did not use local anesthesia.



Injectate, Volume, and Needles Used

The commonly used injectates were D5W, saline, anesthetic, steroid, and combinations of these fluids. Although PRP was mentioned in 4 studies [15,19- 21], only two investigated its effectiveness [15,19]. Hyaluronidase (Hyalase) was mentioned twice but was only investigated by one study [22] and progesterone was only mentioned once [21]. The summary of the combinations of injectates used is presented in Appendix 1. There was great variation seen with regard to the injectate volumes and the needles used. A summary of the injectate volumes is presented in Table 2.

Table 2. Summary of Injectate Volumes Used by the Included Studies

Outcome and Outcome Measures

There were 55 studies that reported on outcome and outcome measures, 17 (44%) of those reported on carpal tunnel syndrome, and 38 (69%) reported on other indications. Of the studies that investigated nerves other than the median nerve at the wrist, pain was the most common outcome (87%), with 36% using the Visual Analog Scale and 33% using Numerical Rating Scale, followed by subjective reports of “paresthesia”, “numbness” or “tingling” (29%), reports on “resolution of symptoms” (11%), strength or manual muscle test (11%), electrodiagnostic findings or nerve conduction velocity studies (11%), and range of motion (ROM) (8%) and ultrasonographic findings (2%). Additional outcome measures were the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, which was used by studies that investigated the proximal median nerve and median nerve, shear wave elastography (shear wave velocity) was used for radial nerve palsy, and the Functional Pelvic Pain Score was for the study on UCPPS.

Of the 17 studies that had information on outcome and outcome measures, the most common outcome measure reported was the Boston Carpal Tunnel Questionnaire (76%), next was pain (53%) and cross-sectional area of the median nerve (53%), electrodiagnostic findings/nerve conduction studies (47%), ultrasonographic findings (12%), “resolution of symptoms” (12%), subjective findings of “paresthesia”, “numbness” or “tingling” (6%), hand grip strength (6%), shear wave elastography (6%), DASH questionnaire (6%), Short-Form 12 (6%), patient satisfaction (6%), and a survey on injection experience (6%). A summary of the outcomes and outcome measures is presented in Table 3.

Table 3. Outcome Measures Used

Adverse Effects

Out of the 70 included studies, only 15 articles reported on the presence or absence of side effects.Twelve studies reported that there were no side effects observed. One study cautioned on the risk of intraneural injection, and another study mentioned the risk of increased numbness and tightness felt during the injection caused by the volume effect of hydrodissection-related dragging effect on the nerve. Though one study reported that no serious adverse events were noted, two patients in the intervention group were noted to have minor post-injection pain on the first day after the intervention, which resolved spontaneously, without the need for additional treatments.


The first aim of this scoping review is to identify the available evidence on nerve hydrodissection. Interestingly, almost half of the 70 studies included were written in the last three years. Aside from this, there are 17 countries that have produced some form of study in the field. An expansion of the application of nerve hydrodissection can also be seen in the number of indications (34) and different nerve targets (25) presented by the included studies. This highlights the growing interest in hydrodissection as an emerging management option for nerve entrapment. It is also noteworthy that Taiwan emerged as the country leading the production of papers on nerve hydrodissection, followed by the USA.

Most of the studies available are case reports and literature reviews, with randomized controlled trials comprising only 13% of the included studies. This underscores the need for more studies with higher-level methodologies to truly examine the effectiveness of nerve hydrodissection on different neuropathies.

The second objective of this review is to clarify the key concepts such as the definition and mechanism of action of hydrodissection. Although there were eight other variations to the terminology “hydrodissection” and “nerve hydrodissection”, the included studies have shown a general uniformity in the definition and mechanism of action of hydrodissection. The pharmacologic effect, specifically the effect of D5W on neuropathic pain is a less well-understood mechanism of benefit of hydrodissection and is a topic worthy of further examination.

The third objective of the study is to report on the available information on the injection techniques, injectate choices, outcomes and outcome measures used, possible adverse effects, and potential application of the procedure to knee osteoarthritis pain management. The included articles varied widely in terms of injection techniques, but this study was able to summarize the techniques and steps common to these studies. This may be helpful in the conduct of future research especially those that aim to develop standardized protocols for ultrasound-guided procedures.

There was also great variation in terms of the injectate, volume, and types of needles used. The general trend seen was the use of D5W or different combinations of D5W, steroid, anesthetic, and saline. However, this trend is too broad to facilitate the development of recommendations for clinical practice. To promote generalizability, more studies are needed to investigate the effectiveness of different injectates and injectate combinations as well as comparisons of different injectate volumes.

This study presented the different outcomes and outcome measures used by the included studies. It is interesting to note that apart from the usual outcomes of pain, strength, ROM, and questionnaires specific to certain indications, newer outcome measures, like shear wave elastography, are being mentioned.

Based on the results of this review, hydrodissection can be considered a relatively safe procedure with only one study mentioning the occurrence of mild post-procedural pain that was spontaneously relieved without additional management. Among the studies included, there was one case report on the possible application of hydrodissection for knee osteoarthritis targeting the peroneal nerve.

The final objective of this study is to identify the gap in the literature. The lack of standardization in the different aspects of hydrodissection presented in this study underscores the need for further research. More studies are needed on nerves that were mentioned in this scoping review as well as other nerves that are potential targets for the relief of nerve entrapment and neuropathic pain. As mentioned, studies on injection technique and choice of injectate are needed to establish the effectiveness of nerve hydrodissection.

Despite attempts to be as comprehensive as possible, this review may not have identified all scoping reviews in the published literature. Authors of the papers that were excluded due to the unavailability of full texts and those without available English translations were not contacted. Furthermore, the authors did not contact any researchers or experts for additional scoping reviews we may have missed.

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Graesser EA, Dy CJ, Brogan DM.

Future considerations in the diagnosis and treatment of compressive neuropa- thies of the upper extremity.

J Hand Surg Glob Online. 2022;5(4):536-546. doi:10.1016/j.jhsg.2022.10.009



Lam KHS, Hung CY, Chiang YP, et al.

Ultrasound-guided nerve hydrodissection for pain management: rationale, methods, current literature, and theoretical mechanisms.

J Pain Res. 2020;13:1957-1968. doi:10.2147/JPR.S247208



Hui J, Seko K, Shrikhande G, et al.

A novel, nonopi- od-based treatment approach to men with urologic chronic pelvic pain syndrome using ultrasound-guided nerve hydrodissection and pelvic floor musculature trig- ger point injections.

Neurourol Urodyn. 2020;39(2):658- 664. doi:10.1002/nau.24242



Peters M, Godfrey C, Mcinerney P, Munn Z, Tricco A, Khalil H.

2017 guidance for the conduct of JBI scoping re- views Chapter 11 : Scoping Reviews Scoping Reviews.

Un- derst Scoping Rev Defin Purp Process. 2017;18(10):2119- 2126.



Tricco AC, Lillie E, Zarin W, et al.

PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation.

Ann Intern Med. 2018;169(7):467-473. doi:10.7326/ M18-0850



untragulpoontawee M, Chang KV, Vitoonpong T, etal.

The effectiveness and safety of commonly used injec- tates for ultrasound-guided hydrodissection treatment of peripheral nerve entrapment syndromes: a systematic review.

Front Pharmacol. 2021:11:621150. doi:10.3389/ fphar.2020.621150



Pollock D, Peters MDJ, Khalil H, et al.

Recommendations for the extraction, analysis, and presentation of results in scoping reviews.

JBI Evid Synth. 2023;21(3):520-532. doi:10.11124/JBIES-22-00123



üeger E, Hutmacher N, Eichelberger P, Löcherbach C, Albrecht S, Romann M.

Ultrasound imaging-based meth- ods for assessing biological maturity during adolescence and possible application in youth sport: a scoping review.

Children (Basel). 2022;9(12):1985. doi:10.3390/CHIL- DREN9121985



Arksey H, O’Malley L.

Scoping studies: towards a methodological framework.

Int J Soc Res Methodol. 2005;8(1):19-32. doi:10.1080/1364557032000119616



Azza KKN, Sofwan S, Wibisono AS.

Ultrasound-guide hydrodissection for ulnar nerve entrapment at arcade of struthers.

J Anaesth Pain. 2022;3(1):17-21. doi:10.21776/ ub.jap.2022.003.01.05



Murugesan A, Raghuraman MS, Chilukuri S, Raja T.

Hydro-dissection of dorsal scapular nerve for neuropathy post radical neck dissection and radiation: a case report.

Indian J Palliat Care. 2021;27(4):577-579. doi:10.25259/ IJPC_114_21



Ryan PJ, Harmon DC.

Ultrasound-guided greater occip- ital nerve hydrodissection for treatment of cervicogenic headache: a case report.

Pain Stud Treat. 2023;11(1):1-8. doi:10.4236/pst.2023.111001



Silver D, Esener D, Rose G.

Ultrasound guided trans- gluteal sciatic nerve hydrodissection for the treatment of acute sciatica in the emergency department.

Am J Emerg Med. 2023;69:216.e3-216.e6. doi:10.1016/ j.ajem.2023.02.026



Tople JP, Bhuyan D.

Ultrasound-guided hydrodis- section of sural nerve for foot pain.

J Pharm Res Int. 2021;33(59A):513-518. doi:10.9734/jpri/2021/ v33i59a34299



Wu YT, Lam KHS, Lai CY, et al.

Novel motor-sparing ul- trasound-guided neural injection in severe carpal tunnel syndrome: a comparison of four injectates.

Biomed Res Int. 2022;2022:9745322. doi:10.1155/2022/9745322



Stoddard JM, Taylor CR, OʼConnor FG.

Ulnar nerve entrapment at the cubital tunnel successfully treated with ultrasound-guided peripheral nerve hydrodissection: a case report and further evidence for a developing treat- ment option.

Curr Sports Med Rep. 2019;18(11):382-386. doi:10.1249/JSR.0000000000000649



Chao TC, Reeves KD, Lam KHS, Li TY, Wu YT.

The effectiveness of hydrodissection with 5% dextrose for persistent and recurrent carpal tunnel syndrome: a retrospec- tive study.

J Clin Med. 2022;11(13):3705. doi:10.3390/ jcm11133705



Chen SR, Ho TY, Shen YP, et al.

Comparison of short- and long-axis nerve hydrodissection for carpal tunnel syndrome: a prospective randomized, single-blind tri- al.

Int J Med Sci. 2021;18(15):3488-3497. doi:10.7150/ ijms.63815



Shen YP, Li TY, Chou YC, et al.

Comparison of perineural platelet-rich plasma and dextrose injections for moder- ate carpal tunnel syndrome: a prospective randomized, single-blind, head-to-head comparative trial.

J Tissue Eng Regen Med. 2019;13(11):2009-2017. doi:10.1002/ TERM.2950



Mangara Y, Siahaan T.

Dextrose hydrodissection with ultrasound-guided as optional therapy in pronator teres syndrome: a case report.

J Clin Case Rep and Stu. 2021;3(3). doi:10.31579/2690-8808/078

CrossRef PDF


Tumpaj T, Potocnik Tumpaj V, Albano D, Snoj Z.

Ultrasound-guided carpal tunnel injections.

Radiol Oncol. 2022;56(1):14-22. doi:10.2478/raon-2022-0004



Elawamy A, Hassanien M, Hamed A, et al.

Efficacy of hyalase hydrodissection in the treatment of carpal tun- nel syndrome: a randomized, double-blind, controlled, clinical trial.

Pain Physician. 2020;23(2):E175-E183. doi:10.36076/ppj.2020/23/e175

CrossRef PDF


Örücü Atar M, Gürçay E, Demir Y, Köroğlu Ö, Tezel K, Yaşar E.

Ultrasound-guided hydrodissection com- bined with peripheral nerve block for the treatment of post-traumatic knee stiffness.

Fiz Tıp ve Rehabil Bilim Derg. 2020;23(1):51-54. doi:10.31609/jpmrs.2019-66307



Elawamy A, Kamel EZ, Mahran SA, Abdellatif H, Hassan- ien M.

Efficacy of genicular nerve radiofrequency ablation versus intra-articular platelet rich plasma in chronic knee osteoarthritis: a single-blind randomized clinical trial.

Pain Physician. 2021;24(2):127-134.

CrossRef PDF


Guo K, McCool L, Wang H, Guo D, Guo D.

The modified ultrasound-guided distal-to-proximal carpal tunnel injection with median nerve hydrodissection: a retrospective safety review of 827 procedures.

Hand (N Y). 2021;16(3):407-409. doi:10.1177/1558944719861715



He JJ, Wei XM, Dou ZL, et al.

Ultrasound-guided nerve hydrodissection with 5% dextrose 4 weeks after ste- roid injection in treatment of carpal tunnel syndrome: a retrospective study.

Front Neurol. 2022;12:782319. doi:10.3389/fneur.2021.782319



Li TY, Chen SR, Shen YP, et al.

Long-term outcome after perineural injection with 5% dextrose for carpal tunnel syndrome: a retrospective follow-up study.

Rheumatology (Oxford). 2021;60(2):881-887. doi:10.1093/RHEUMA- TOLOGY/KEAA361



Lin MT, Liao CL, Hsiao MY, Hsueh HW, Chao CC, Wu CH.

Volume matters in ultrasound-guided perineural dextrose injection for carpal tunnel syndrome: a random- ized, double-blinded, three-arm trial.

Front Pharmacol. 2020;11:625830. doi:10.3389/fphar.2020.625830



Lin MT, Liu IC, Syu WT, Kuo PL, Wu CH.

Effect of perineural injection with different dextrose volumes on medi- an nerve size, elasticity and mobility in hands with carpal tunnel syndrome.

Diagnostics (Basel). 2021;11(5):849. doi:10.3390/diagnostics11050849



Mathieu T, Lemmens E, Stassijns G.

A safe and easy-to- use ultrasound-guided hydrodissection technique for the carpal tunnel syndrome: a minimally invasive approach.

J Ultrasound. 2022;25(3):451-455. doi:10.1007/s40477-021- 00597-5



Schrier VJMM, Brault JS, Amadio PC.

Ultrasound-guided hydrodissection with corticosteroid injection in the treatment of carpal tunnel syndrome: a pilot study.

J Ultrasound Med. 2020;39(9):1759-1768. doi:10.1002/ JUM.15279



Shah N, Clearfield D.

Nerve hydrodissection for im- pingement of the suprascapular nerve. University of North Texas Health Science Center (HSC) website.

Published March, 2015. dle/20.500.12503/26477. Accessed June 27, 2023.



Wang JC, Hsu PC, Wang KA, Chang KV.

Ultrasound-guided triamcinolone acetonide hydrodissection for carpal tunnel syndrome: a randomized controlled trial.

Front Med (Lausanne). 2021;8:742724. doi:10.3389/ fmed.2021.742724



Wu YT, Ho TY, Chou YC, et al.

Six-month efficacy of perineural dextrose for carpal tunnel Syndrome: a pro- spective, randomized, double-blind, controlled trial.

Mayo Clin Proc. 2017;92(8):1179-1189. doi:10.1016/ j.mayocp.2017.05.025



Wu YT, Chen SR, Li TY, et al.

Nerve hydrodissection for carpal tunnel syndrome: a prospective, randomized, dou- ble-blind, controlled trial.

Muscle Nerve. 2019;59(2):174- 180. doi:10.1002/MUS.26358



Zhang R, Chen B, Stitik TP, Foye PM.

Poster 252 longi- tudinal approach for ultrasound‐guided hydrodissec- tion for carpal tunnel syndrome: a case report.

PM&R. 2014;6(9S):S273. doi:10.1016/j.pmrj.2014.08.639



Chiang CF, Cheng SH, Wu CH, Özçakar L.

Video demonstration of ultrasound-guided hydrodissection for superficial peroneal nerve entrapment.

Pain Med. 2020;21(7):1509-1510. doi:10.1093/PM/PNAA049



Mat CKB, Suhaimi A.

Nerve hydrodisssection: a ther- apeutic injection for complex regional pain syndrome.

ePMJ. 2022;2(Suppl 1). index.php/pmj/article/view/19105. Published August 15, 2022. Accessed April 15, 2022.



Song B, Marathe A, Chi B, Jayaram P.

Hydrodissection as a therapeutic and diagnostic modality in treating pe- roneal nerve compression.

Proc (Bayl Univ Med Cent). 2020;33(3):465-466. doi:10.1080/08998280.2020.1758006



Tabor M, Emerson B, Drucker R, Brunk E.

High-stepping cross-country athlete: a unique case of foot drop and a novel treatment approach.

Curr Sports Med Rep. 2017;16(5):314-316. doi:10.1249/JSR.0000000000000396



Wu WT, Chang KV, Özçakar L.

Ultrasound imaging and guided hydrodissection in the management of a postamputation deep peroneal neuroma.

Pain Pract. 2020;20(6):695-696. doi:10.1111/papr.12889



Zarate RP Jr., Gonzalez-Suarez CB, Ortega CV, Ledesma AL.

Knee osteoarthritis: looking beyond the common pain generators. A case report and review of literature.

Asia Pacific J Pain. 2023;33(1):11-15. doi:10.29760/ APJP.202303_33(1).0004



Chen SR, Shen YP, Ho TY, Chen LC, Wu YT.

Ultrasound-guided perineural injection with dextrose for treatment of radial nerve palsy: a case report.

Med- icine (Baltimore). 2018;97(23):e10978. doi:10.1097/ MD.0000000000010978



Su DCJ, Chang KV, Lam SKH.

Shear wave elastography to guide perineural hydrodissection: two case reports.

Diagnostics (Basel). 2020;10(6):348. doi:10.3390/diag- nostics10060348



Van Tassel CJ, Hu YWE.

Perineural hydrodissection for superficial radial nerve compression neuropathy: a case report.

Res Inves Sports Med. 2022;8(4):RISM.000694. doi:10.31031/RISM.2022.08.000694



Wei KC, Wu CH, Özçakar L.

Ultrasound imaging and guidance in the diagnosis and hydrodissection of superficial radial nerve entrapment after fracture surgery.

Pain Med. 2020;21(9):2001-2002. doi:10.1093/PM/PNAA118



Chen LC, Ho TY, Shen YP, et al.

Perineural dextrose and corticosteroid injections for ulnar neuropathy at the elbow: a randomized double-blind trial.

Arch Phys Med Rehabil. 2020;101(8):1296-1303. doi:10.1016/j.ap- mr.2020.03.016



Clendenen S, Greengrass R, Whalen J, O’Connor MI.

Infrapatellar saphenous neuralgia after TKA can be im- proved with ultrasound-guided local treatments.

Clin Or- thop Relat Res. 2015;473(1):119-125. doi:10.1007/S11999- 014-3812-6



Shi GG, Schultz DS Jr, Whalen J, Clendenen S, Wilke BK.

Midterm outcomes of ultrasound-guided local treatment for infrapatellar saphenous neuroma following total knee arthroplasty.

Cureus. 2020;12(1):e6565. doi:10.7759/cu- reus.6565



Watanabe K, Tokumine J, Lefor AK, Moriyama K, Yorozu T.

Ultrasound-guided hydrodissection of an entrapped saphenous nerve after lower extremity varicose vein stripping: a case report.

A A Pract. 2020;14(1):28-30. doi:10.1213/XAA.0000000000001143



Mulvaney SW.

Ultrasound-guided percutaneous neuroplasty of the lateral femoral cutaneous nerve for the treatment of meralgia paresthetica: a case report and description of a new ultrasound-guided technique.

Curr Sports Med Rep. 2011;10(2):99-104. doi:10.1249/ JSR.0B013E3182110096



Su YC, Lee CY, Chang CY, Chen LC, Wu YT.

Efficacy of nerve hydrodissection with 5% dextrose in chronic meralgia paresthetica.

Pain Pract. 2020;20(5):566-567. doi:10.1111/PAPR.12870



Tople J, Mago V, Chakole V, Bharadwaj Y.

Successful management of meralgia paresthetica by hydro dis- section in a middle-aged male: a case report.

Cureus. 2022;14(6):e25945. doi:10.7759/cureus.25945



Burke CJ, Walter WR, Adler RS.

Targeted ultrasound-guid- ed perineural hydrodissection of the sciatic nerve for the treatment of piriformis syndrome.

Ultrasound Q. 2019;35(2):125-129. doi:10.1097/RUQ.0000000000000360



Chen B, Stitik TP, Foye PM, Roque-Dang CM, Lai LP.

Successful treatment of sciatica and associated proximal hamstring tendinopathy with ultrasound-guided hydro- dissection.

PM&R. 2013;5(9S):S223. doi:10.1016/ rj.2013.08.341



Heng YY, Koh E, Boyle J.

Ultrasound guided percutane- ous neurolysis for sciatic nerve tethering post mid-ham- string tendon repair.

J Orthop Sports Med. 2020;2(1):35- 41. doi:10.26502/josm.511500020



Sharma GK, Botchu R.

Dorsal scapular nerve entrapment neuropathy managed by ultrasound-guided hydrodis- section—a case report.

J Ultrason. 2021;21(84):74-76. doi:10.15557/JoU.2021.0012



Fader RR, Mitchell JJ, Chadayammuri VP, Hill J, Wol- cott ML.

Percutaneous ultrasound-guided hydrodissection of a symptomatic sural neuroma.

Orthopedics. 2015;38(11):e1046-e1050. doi:10.3928/01477447- 20151020-15



Siahaan YMT, Herlambang J, Putri C, Tiffani P.

Ultrasound-guided perineural dextrose injection for treatment of superior cluneal nerve entrapment: serial case report.

Open Pain J. 2021;14(1):32-37. doi:10.2174/1876386302114010032



Wu WT, Mezian K, Naňka O, Chang KV, Özçakar L.

Ultrasonographic imaging and guided intervention for the superior cluneal nerve: a narrative pictorial review.

Pain Physician. 2022;25(4):E657-E667.



Chang KV, Wu WT, Hsu PC, Yang YC, Özçakar L.

Ultrasonography in pronator teres syndrome: dynamic examination and guided hydrodissection.

Pain Med. 2022;23(1):219-220. doi:10.1093/pm/pnab143



Yen YS, Su DCJ, Chou W.

Poster 444: ultrasound‐guided hydrodissection of superficial cervical plexus in patient with severe neck pain after neck lymphoma excision surgery: a case report.

PM&R. 2017;9(9S1):S273-S274. doi:10.1016/J.PMRJ.2017.08.384



Sahoo RK, Peng PWH, Sharma SK.

Ultrasound-guided hydrodissection for Baxter’s neuropathy secondary to plan- tar fasciitis: a case report.

A A Pract. 2020;14(13):e01339. doi:10.1213/XAA.0000000000001339



Wu CH, Boudier-Revéret M.

Ultrasound-guided steroid injections for lateral antebrachial cutaneous nerve entrap- ment within postsurgical scar.

Am J Phys Med Rehabil. 2019;98(9):e106. doi:10.1097/PHM.0000000000001150



Tang JZ, Nie MJ, Zhao JZ, Zhang GC, Zhang Q, Wang B.

Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis.

J Orthop Surg Res. 2020;15(1):403. doi:10.1186/s13018-020-01919-9