LD-PRP Hydrodissection · perineural therapy
Low-density PRP & PPP hydrodissection.
Autologous, low-inflammatory plasma-based injectates delivered under ultrasound guidance to free entrapped nerves from surrounding fascia and scar, for carpal tunnel, peripheral entrapment, and perineural pain syndromes.
HYDRODISSECTION
What is hydrodissection?
Nerve hydrodissection is the technique of using fluid pressure, delivered through a needle under real-time ultrasound, to separate a peripheral nerve from the surrounding fascia, scar, or compressing structure. The mechanical release alone can relieve entrapment-related pain and improve nerve gliding.
Using an autologous plasma fraction as the dissection fluid, either low-density PRP or platelet-poor plasma, adds a biologic signaling component: trophic factors that may support nerve health beyond the mechanical effect of release.
LD-PRP
Reduced platelet concentration · neurotrophic profile
Lower-concentration PRP prepared specifically for perineural use. The platelet concentration is below the level that drives a strong inflammatory cascade, well-tolerated around sensitive neural tissue while still delivering growth-factor signaling.
PPP
No platelets · pure plasma protein
The acellular fraction of your processed blood. Delivers plasma proteins (albumin, IGF-1, fibrinogen) and provides effective hydrodissection volume without platelet-driven inflammatory response. Preferred in highly sensitive perineural settings.
Regulatory Considerations
Low-density PRP and PPP are autologous biologic preparations derived from a patient's own blood. These products are not approved by the U.S. Food and Drug Administration (FDA) as drugs or biologics for the treatment of specific musculoskeletal or neuropathic conditions. Their clinical use is based on physician judgment, current scientific evidence, and individualized patient evaluation. No claims are made regarding guaranteed outcomes, tissue regeneration, or disease modification.
What we treat
Nerve entrapment and perineural pain syndromes.
Hydrodissection is most useful where a peripheral nerve is mechanically restricted, by fascia, scar, post-surgical adhesion, or repetitive-use thickening, and the entrapment can be confirmed by ultrasound.
Carpal tunnel
Median nerve entrapment at the wrist.
Cubital tunnel
Ulnar nerve entrapment at the elbow.
Tarsal tunnel
Posterior tibial nerve at the ankle.
Peroneal nerve
Common peroneal entrapment near the fibular head.
Scar adhesions
Post-surgical adhesions tethering peripheral nerves.
Meralgia paresthetica
Lateral femoral cutaneous nerve entrapment.
Suprascapular
Suprascapular nerve at the scapular notch.
Case-by-case
Other peripheral nerve syndromes with ultrasound-visible entrapment.
The procedure
What to expect during the visit
We'll use ultrasound to guide a fluid around the entrapped nerve to allow the fluid pressure to release it from the surrounding structures.
Ultrasound assessment
Targeted ultrasound to visualize the entrapment and plan the dissection path.
Blood draw
Small venous draw for autologous LD-PRP or PPP preparation.
Preparation
Centrifugation in our on-site lab, LD-PRP or PPP depending on indication and nerve sensitivity.
Hydrodissection
Under continuous ultrasound, the prepared injectate is delivered around the nerve, separating it from adhesions and compressing structures.
Recovery & follow-up
Brief observation. Activity guidance specific to the nerve treated. Follow-up at 2, 6, and 12 weeks.
Is this you?
When hydrodissection is the right tool.
Hydrodissection works best when the entrapment can be confirmed by exam, EMG/NCS, or ultrasound, and when surgical release isn't yet warranted or hasn't fully resolved symptoms.
✓ Likely a fit
- Carpal tunnel, cubital, tarsal, or other peripheral entrapment, mild-to-moderate
- Post-surgical perineural scarring with persistent symptoms
- EMG/NCS or ultrasound confirms entrapment
- Failed splinting, PT, or activity modification
- Want to defer or avoid surgical release
Frequently asked
LD-PRP & PPP hydrodissection, answered.
Why use plasma rather than saline or steroid? +
Saline dissects mechanically but offers no biologic signal, the effect can be transient. Steroid is anti-inflammatory but is locally toxic to nerve tissue with repeat exposure. Autologous LD-PRP/PPP combines mechanical release with a neurotrophic signaling profile and is well-tolerated for repeat treatment if needed.
Why LD-PRP rather than standard PRP? +
Standard PRP delivers a higher platelet concentration and a stronger inflammatory cascade, appropriate for joints and tendons, but can be irritating around sensitive perineural tissue. LD-PRP uses a deliberately reduced concentration that's well-tolerated near nerves. Even lower-sensitivity targets (severe entrapments, post-surgical scarring) often do better with PPP, which removes platelets entirely.
How does this compare to surgical release? +
Surgical release is the definitive treatment for severe entrapment with axonal loss. Hydrodissection is most useful for mild-to-moderate entrapment, post-surgical persistent symptoms, or as a step before considering surgery. It's reversible, repeatable, and doesn't preclude surgery if needed later.
How long until I feel a difference? +
Many patients report immediate relief from the mechanical release portion: the nerve glides better as soon as it's separated from compressing tissue. Sustained improvement typically develops over 2–6 weeks as the biologic signaling effects unfold. Some cases need a repeat treatment at 6–8 weeks.
Does insurance cover this? +
No. Autologous PRP/PPP procedures are considered investigational by most insurers and are out-of-pocket. We provide transparent pricing during consultation and supply HSA/FSA reimbursement documentation where applicable.
Related therapies
Adjacent options.
Schedule a hydrodissection consultation
Find out if hydrodissection fits your case.
Dr. Glowney reviews your EMG/NCS, imaging, and exam, then confirms entrapment with point-of-care ultrasound. Honest assessment of whether hydrodissection, surgical release, or another path is the right next step.
Or call 720-550-6175