Nerve compression by surrounding musculoskeletal and connective tissues creates a cascade of biological and biophysical signaling resulting in release of inflammatory and immune mediators, as well as mechanical injury to the nerve and surrounding structures itself. Visualization of peripheral nerves and surrounding structures with dynamic ultrasound have enabled appropriately trained clinicians to more accurately and safely target compressed nerves for hydrodissection. Successful hydrodissection of nerves can result in relief of nerve-related pain, and increased sensation and motor activity of the affected nerve distribution potentially leading to improved function of the affected anatomic site.

This symposium will elucidate the biological and biophysicial milieu surrounding a compressed peripheral nerve, and review the evidence that exists for various chemical preparations used in hydrodissecting nerve tissue, and how efficacious or toxic such preparations may be to nerves and surrounding tissue structures. We will also present example video cases of nerves more commonly released by hydrodissection, such as the median, ulnar, saphenous, and lateral femoral cutaneous nerves, detailing the preparations used and evidence supporting their use.