LD-PRP Hydrodissection · perineural therapy
Low-density PRP & PPP hydrodissection.
Fluid made from your own blood, either low-density PRP or platelet-poor plasma, injected around a trapped nerve under ultrasound guidance. The fluid separates the nerve from the tissue or scar pressing on it. We use it for carpal tunnel syndrome, other nerve entrapments, and pain around nerves.
HYDRODISSECTION
What is hydrodissection?
Nerve hydrodissection uses fluid, injected through a needle under live ultrasound, to separate a nerve from the tissue around it: fascia (the sheets of connective tissue around muscles), scar, or anything else pressing on it. Freeing the nerve this way can ease pain from the entrapment and help the nerve slide normally again.
Using fluid made from your own plasma, either low-density PRP or platelet-poor plasma, adds growth factors that may support nerve health beyond the physical release.
LD-PRP
Reduced platelet concentration · neurotrophic profile
Lower-concentration PRP prepared specifically for perineural use. The platelet level is kept below the point that sets off a strong inflammatory response, so it's better tolerated near sensitive nerve tissue while still carrying growth factors.
PPP
Very few platelets · plasma proteins
The liquid part of your processed blood, with very few cells. 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.
Where it's used
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 use ultrasound to guide fluid around the trapped nerve. The pressure of the fluid separates the nerve from the structures around it.
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.
Talking it through
When hydrodissection is the right tool.
Hydrodissection is used when a trapped nerve shows up on exam, nerve testing (EMG/NCS, electromyography and nerve conduction studies), or ultrasound, and when surgery isn't yet needed or hasn't fully relieved symptoms.
What we look at together
- Mild-to-moderate carpal tunnel, cubital tunnel, tarsal tunnel, or another nerve entrapment
- Scarring around a nerve after surgery, with ongoing symptoms
- Nerve testing or ultrasound results, if you have them
- Symptoms that continue despite splinting, physical therapy, or activity changes
- Wanting to delay or avoid surgical release
Frequently asked
LD-PRP & PPP hydrodissection, answered.
Why use plasma rather than saline or steroid? +
Saline separates the nerve mechanically but carries no growth factors, and its effect can be short-lived. Steroid calms inflammation, but repeated steroid injections near a nerve may harm nerve tissue. Low-density PRP or platelet-poor plasma from your own blood gives the same mechanical release plus growth-factor signaling, and it can be repeated if needed.
Why LD-PRP rather than standard PRP? +
Standard PRP has more platelets and sets off a stronger inflammatory response. That suits joints and tendons but can irritate the sensitive tissue around nerves. Low-density PRP has deliberately fewer platelets and is better tolerated near nerves. For the most sensitive cases, such as scarring after surgery, we often use platelet-poor plasma, which has very few platelets.
How does this compare to surgical release? +
Surgical release is the established treatment for severe entrapment with nerve damage (axonal loss). Hydrodissection is most useful for mild-to-moderate entrapment, for symptoms that continue after surgery, or as a step before considering surgery. It can be repeated, and it doesn't rule out surgery later.
How long until I feel a difference? +
Some people notice a change soon after the procedure, from the physical release of the nerve. When improvement continues, it usually builds over 2 to 6 weeks. Some people need a repeat treatment at 6 to 8 weeks.
Does insurance cover this? +
No. Autologous PRP/PPP procedures are not covered by most insurers and are out-of-pocket. We discuss the cost with you when you book your service and supply HSA/FSA reimbursement documentation where applicable.
Related therapies
Related treatments.
Schedule a call
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.
720-550-6175