How Carpal Tunnel Hydrodissection Can Help You Avoid Surgery
By Dr. Iridi Pavliqoti, MD, CAQSM with CMC Orthopaedics
Are your hands frequently numb or tingling? Do you find yourself dropping objects unexpectedly or waking up in the middle of the night with hand pain? You might be experiencing carpal tunnel syndrome, a common condition that affects millions of Americans each year. While surgery has traditionally been the go-to solution for persistent cases, there’s a minimally invasive alternative worth considering: carpal tunnel hydrodissection.
Understanding Carpal Tunnel Syndrome
To understand carpal tunnel syndrome, imagine your wrist as a busy underground tunnel. Through this tunnel runs an important highway (the median nerve) that carries signals between your brain and hand. Above this nerve is a rigid bridge (the transverse carpal ligament) that forms the roof of the tunnel.
When inflammation occurs due to repetitive hand movements, injury, or certain health conditions, the tunnel becomes congested. This congestion puts pressure on the median nerve, causing the telltale symptoms of carpal tunnel syndrome:
- Numbness and tingling in the thumb, index, middle, and part of the ring finger
- Hand weakness and difficulty gripping objects
- Wrist pain that may extend up the arm
- Symptoms that worsen at night
What is Carpal Tunnel Hydrodissection?
Hydrodissection is like creating a detour around the traffic jam in your wrist. Using ultrasound guidance for precision, I inject a solution (typically a mixture of sterile sugar water (D5W), an anesthetic, and sometimes a steroid) around the compressed median nerve.
Think of it as carefully power-washing away adhesions and scar tissue that may be binding the nerve to surrounding structures. The fluid gently separates the nerve from these surrounding tissues, creating a protective cushion that gives the nerve breathing room.
The Benefits of Hydrodissection
Unlike surgery, which involves cutting the transverse carpal ligament to create more space, hydrodissection:
- Is performed in the office under local anesthesia
- Takes approximately 15-20 minutes
- Requires minimal to no downtime
- Doesn’t involve incisions or stitches
- Can be repeated if needed
- Provides immediate relief to the majority of patients
Is Hydrodissection Right for You?
Hydrodissection tends to work best for patients with mild to moderate carpal tunnel syndrome, particularly if:
- You’ve tried conservative treatments like wrist splints, activity modification, and anti-inflammatory medications without success
- You want to avoid or delay surgery
- You have medical conditions that make surgery riskier
- You need a quicker recovery than surgery allows
It’s important to note that not everyone is a candidate for this procedure. Severe cases with significant nerve damage or atrophy of the hand muscles may still require surgical intervention.
What to Expect During and After the Procedure
During your appointment, I’ll use ultrasound imaging to precisely visualize your median nerve and the surrounding structures. After cleaning the area and applying a local anesthetic, I’ll guide a small needle to the proper location and slowly inject the solution around the nerve.
Most patients experience minimal discomfort during the procedure. Afterward, you might notice:
- Some soreness at the injection site for 24-48 hours
- Gradual improvement in symptoms over the following days to weeks
- Return to most normal activities within the next 24 hours
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When Surgery May Still Be Necessary
While hydrodissection offers an excellent non-surgical option, some patients may eventually need surgical release if:
- Symptoms don’t improve after one or two hydrodissection procedures
- Nerve testing shows significant nerve damage
- Hand weakness continues to progress
- Symptoms return after initial improvement
At CMC Orthopaedics, we offer comprehensive surgical solutions for carpal tunnel syndrome when necessary. These procedures are performed by our experienced surgical team using the latest techniques to ensure the best possible outcomes.
Take the First Step Toward Relief
If you’re struggling with carpal tunnel syndrome symptoms, don’t wait until the pain affects your quality of life. Early intervention often leads to better outcomes with less invasive treatments.
I’m Dr. Iridi Pavliqoti, MD, CAQSM, a fellowship-trained sports medicine physician at CMC Orthopaedics, specializing in non-surgical treatments for musculoskeletal conditions. I’m passionate about helping patients find relief using the least invasive methods possible.
To schedule a consultation and learn whether carpal tunnel hydrodissection might be right for you, contact CMC Orthopaedics today at 843-347-8041. Together, we’ll develop a personalized treatment plan to get you back to the activities you love—without the numbness, pain, and limitations of carpal tunnel syndrome.
Dr. Iridi Pavliqoti, MD, CAQSM
CMC Orthopaedics- Socastee
Dr. Iridi Pavliqoti is a dual board-certified Primary Care Sports Medicine physician. Dr.Pavliqoti earned his medical degree from Ross University School of Medicine before completing his family medicine residency at Case Western Reserve University/The MetroHealth System in Cleveland, Ohio. He then went on to complete a sports medicine fellowship at LSU Health Science Center in Lafayette, Louisiana.
