Nerve Hydrodissection as Treatment for Entrapment Neuropathies: A Literature Review

Entrapment neuropathies are disorders in which peripheral nerves are affected at anatomically restricted sites or at locations where they are vulnerable to external compression. They are prevalent in the general population and may lead to pain, sensory disturbances, and functional impairment. In recent years, nerve hydrodissection has gained attention as a minimally invasive, ultrasound-guided treatment option for entrapment neuropathies. This technique involves the injection of different substances into the perineural space to mechanically separate the nerve from adjacent tissues and potentially reduce compression. The aim of this narrative review was to summarize recent evidence regarding the clinical utility of nerve hydrodissection in the management of entrapment neuropathies in different anatomical regions. The available literature indicates that nerve hydrodissection is associated with meaningful improvements in pain and functional outcomes across a variety of entrapment neuropathies, with the largest body of evidence related to carpal tunnel syndrome. Overall, 5% dextrose in water has emerged as a commonly used injectate with a favorable clinical profile. Nerve hydrodissection appears to be a promising addition to conservative treatment strategies for entrapment neuropathies, particularly in mild to moderate cases. Future studies should focus on entrapment neuropathies other than carpal tunnel syndrome to provide higher-quality and more comprehensive evidence in these conditions.