Dr. Tandon Highlights Long-Term Carpal Tunnel Relief From Hydrodissection

Carpal tunnel syndrome treatment using ultrasound-guided saline hydrodissection provides lasting relief and reduces nerve swelling compared to corticosteroid injections alone, according to findings published in a recent Radiology article.

Ultrasound-Guided Saline Hydrodissection Delivers Long-Term Relief for Carpal Tunnel Patients

Patients suffering from carpal tunnel syndrome experienced significant clinical improvements at four weeks following treatment across all study groups, rsna.org reported. However, the benefits of hydrodissection were sustained and continued to improve over subsequent follow-up periods. Dr. Tandon noted that at 12 weeks and six months, both hydrodissection groups demonstrated further improvement in clinical symptoms and function.

In contrast, patients who received corticosteroid injections alone experienced a recurrence of symptoms, indicating that their initial benefit was short-lived. Mixing corticosteroids into the hydrodissection fluid failed to yield any meaningful extra long-term advantage over using saline hydrodissection by itself. Ultrasound findings supported these clinical results by showing a greater reduction in nerve swelling.

Median Nerve Cross-Sectional Area Decreases Significantly After Procedure

The cross-sectional area of the median nerve decreased by approximately 43% to 45% following hydrodissection. Meanwhile, the median nerve area decreased by approximately 15% following corticosteroid injection alone. Dr. Tandon stated that most patients had suffered from carpal tunnel syndrome for months to years without finding relief from pain medications, splints, lifestyle modifications, and corticosteroids.

It came as a pleasant surprise to find that a simple procedure of dissecting the median nerve under ultrasound guidance with normal saline provided them long-term relief.

Dr. Tandon

The procedure took only 15 minutes on average, and patients tolerated it well without significant immediate or delayed complications. Questionnaire scores indicated high patient satisfaction. The treatment required no anesthesia or hospitalization, cost little, and allowed patients to return to work within an hour.

Future Multicenter Trials Will Compare Dextrose and Saline Injectates

The study results suggest that ultrasound-guided saline hydrodissection is a safe, minimally invasive treatment providing sustained clinical and morphological improvement for refractory carpal tunnel syndrome. Researchers stated that hydrodissection merits consideration as an option for mild to moderate carpal tunnel syndrome to defer or alleviate the need for surgery. Future multicenter studies with larger cohorts and longer follow-up periods remain warranted.

The research team has already launched a study comparing the long-term effectiveness of different injectates, such as dextrose versus saline, in carpal tunnel hydrodissection. According to Dr. Tandon, this trial incorporates an extended follow-up phase to monitor patient outcomes over time and determine the genuine longevity of the therapy.