Nerve hydrodissection and nerve blocks in Hyderabad

What are nerve hydrodissection and nerve blocks?

Nerve hydrodissection is a non-surgical procedure in which fluid is injected under ultrasound around a trapped (entrapped) nerve to separate it from the tissue that is pressing on or sticking to it. A nerve block is an injection placed on or beside a specific nerve to calm it, or to test whether it is the source of the pain.

At Halcyon in Hyderabad these form one pathway: freeing a nerve that is squeezed, and quietening one that is firing.

How they work

Hydrodissection works by using a carefully placed volume of fluid to open up a space around a nerve that has become compressed or stuck. Healthy nerves glide as you move; when scar tissue, a thickened band or swollen tissue presses on one, it can cause pain, tingling or numbness. The fluid, usually saline and sometimes with local anaesthetic or dextrose, is watched on ultrasound as it lifts the tissue away. Relief often begins on the table.

A nerve block delivers medicine, usually a local anaesthetic and sometimes a steroid, to a precise point. Used diagnostically, a block that settles the pain is the strongest evidence available that the right structure has been found. Used as treatment, it can calm an irritated nerve so that movement and rehabilitation become possible.

Which conditions they help

At Halcyon, hydrodissection and nerve blocks are most often used for these conditions. The named procedure depends on what the scan and examination show.

• Elbow, hand and wrist pain, such as carpal tunnel syndrome — nerve hydrodissection
• Sciatica — a transforaminal or epidural injection placed at the irritated nerve root
• Slipped disc pressing on a nerve root — an image-guided epidural injection
• Shoulder pain and frozen shoulder — a suprascapular nerve block, often with hydrodilatation
• Low back pain — a diagnostic or medial branch block to prove which structure is the source

Who they suit, and who they do not

Hydrodissection usually suits people with symptoms of a trapped nerve — pain, pins and needles or numbness in the area that nerve supplies — where ultrasound shows the nerve being compressed. Nerve blocks suit people whose pain source needs confirming, or whose irritated nerve needs calming so that exercise and recovery can proceed.

They are not a substitute for urgent surgical assessment when there is severe or worsening weakness, or loss of bladder or bowel control. An active infection at the site, some bleeding problems, or poorly controlled diabetes may mean the procedure is delayed or changed, so tell the team about your health and medicines when you book.

The procedure, step by step

Most of these procedures are completed in a single appointment at the Kukatpally centre, and most people are home within about two hours.

1. The consultant takes your history and examines you, including nerve function.
2. The nerve or structure is scanned with diagnostic ultrasound in the same room.
3. If a procedure is right, the skin is cleaned and numbed with local anaesthetic.
4. Under live imaging, a fine needle is guided to the nerve or to the chosen level of the spine.
5. For hydrodissection, fluid is injected in stages to free the nerve along its course; for a block, the medicine is placed at the target.
6. Your symptoms are checked, which for a diagnostic block helps decide the next step.
7. You rest briefly, receive aftercare instructions and a review date, and go home.

Recovery and aftercare

Most people walk out after hydrodissection or a nerve block and go about a normal day. The area may feel numb or heavy for a few hours while the local anaesthetic wears off, so take care with that limb and follow the advice you are given about driving.

Note how your pain changes over the following hours and days, especially after a diagnostic block, as this guides the plan. Gentle movement is usually encouraged; a stretching, splinting or exercise programme may be suggested to keep the nerve gliding freely.

Safety and side effects

These procedures are generally well tolerated. Common effects are temporary numbness or weakness in the area supplied by the nerve, soreness and bruising at the needle site, and sometimes a short flare of symptoms. If a steroid is used, people with diabetes may notice a temporary rise in blood sugar.

Serious complications such as infection, bleeding or nerve injury are uncommon; ultrasound lets the consultant see the nerve and needle throughout. Seek urgent care for fever, spreading redness, new or worsening weakness, or loss of bladder or bowel control.