US-Guided Hydro-dissection of peripheral nerves for Neuromusculoskeletal Pain
This lecture will provide an introduction and overview of ultrasound-guided hydrodissection, an innovative technique for the treatment of neuromusculoskeletal pain conditions. Hydrodissection involves the injection of sterile fluid, such as dextrose or saline, under real-time ultrasound guidance to separate and "free up" entrapped or irritated peripheral nerves. The lecture will cover the scientific rationale behind hydrodissection, including the pathophysiology of nerve entrapment and the proposed mechanisms by which hydrodissection may provide pain relief. It will discuss the various peripheral nerve entrapment syndromes that can be targeted with this approach, such as carpal tunnel syndrome. Detailed procedural steps for performing ultrasound-guided hydrodissection will be outlined, including patient positioning, probe placement, needle guidance, and injection techniques. The lecture will highlight the importance of meticulous ultrasound imaging to accurately identify the target nerve and surrounding anatomy. Clinical evidence supporting the efficacy of ultrasound-guided hydrodissection will be reviewed, drawing from recent studies that have demonstrated significant improvements in pain, function, and quality of life for patients with various neuromusculoskeletal pain conditions. Potential risks and complications associated with the procedure will also be discussed. The lecture will conclude by exploring future directions and emerging applications of ultrasound-guided hydrodissection. US-Guided Hydro-dissection of spinal axial nerves for multisite and Poorly Localised Pain This lecture will explore the use of ultrasound-guided hydrodissection as a novel intervention for the management of multisite and poorly localized neuromusculoskeletal pain. Unlike peripheral nerve entrapment syndromes, many chronic pain conditions involve the spinal axial nerves, which can be challenging to diagnose and treat using traditional methods. The lecture will begin by discussing the anatomy and pathophysiology of spinal axial nerves, highlighting their role in the transmission and perpetuation of diffuse, multifocal pain. The rationale for using hydrodissection to address these complex pain patterns will be presented, emphasizing the potential to reduce inflammation, improve nerve glide, and restore normal nerve function. The lecture will provide a detailed overview of the ultrasound-guided hydrodissection technique as it pertains to spinal axial nerves. This will include patient selection criteria, the identification of target nerves using advanced ultrasound imaging, and the step-by-step procedural approach. Particular attention will be paid to the unique challenges and considerations involved in treating axial nerve structures compared to peripheral nerves. The presentation will review the available clinical evidence supporting the use of ultrasound-guided hydrodissection for the management of multisite and poorly localized pain conditions, such as chronic low back pain, myofascial pain syndromes, and atypical neuropathies. Case studies will be used to illustrate the potential benefits of this technique. Finally, the lecture will discuss emerging research directions and future applications of ultrasound-guided hydrodissection for spinal axial nerves, including the integration of this technique into comprehensive pain management strategies. Attendees will gain a deeper understanding of how this innovative approach can be leveraged to improve outcomes for patients suffering from complex, multifocal neuromusculoskeletal pain. Biography MBBS (HK), FHKIMM, MScSEM, MScSMHS, PGDipMSM (Otago), RMSK, CIPS, FIPP, POCUS (MSK) Dr Lam is a musculoskeletal, sports and pain physician from Hong Kong. Dr. Lam has the following affiliations:
Dr. Lam has RMSK and POCUS (MSK-Tissues) credentials in USA and awarded RMSK Pioneer Certificate in 2012. He has passed certifications in CIPS and FIPP by the World Institute of Pain (WIP) in 2017. He has been a teaching-faculty and Examiner of WIP since 2018. Dr. Lam has delivered numerous international lectures and hands-on workshops in the following topics: “Ultrasound-guided hydrodissection of nerves”; “Dynamic MSK Ultrasound Scanning of Joints and Nerves”; “Ultrasound-guided Spine Injection”; and “Ultrasound-guided Regenerative injection therapy/ medicine for managing sports injury, musculoskeletal and chronic pain”. Dr. Lam’s ORCID: https://orcid.org/0000-0003-1392-829X Dr. Lam’s research interests are: A. Musculoskeletal Ultrasound Guided Hydrodissection/ Hydrorelease of Nerves Impingement or Entrapment problems to treat neuromuscular pain. B. Dynamic Musculoskeletal Ultrasound scanning for Assisting Diagnosing and Managing Musculoskeletal problems. C. Ultrasound guided regenerative medicine treatment for pain from sports injuries, degenerations and chronic neuropathic pain. D. US-assisted intraosseous regenerative injection therapy E. US-guided dry needling for different neuromusculoskeletal pain. |