Services Offered by Dr. Mahooti
What is Nerve Hydrodissection / Decompression?
A gentle, nearly painless, advanced ultrasound-guided injection technique that targets the soft tissues adjacent to pinched / entrapped nerves, decompressing them and providing immediate pain relief and improved function.
What are Nerve Entrapments? What Symptoms do they Cause?
Nerves are like electrical wires that originate in the central nervous system (brain and spinal cord) and carry messages to and from every part of the body. Sometimes, after trauma, repetitive use, malalignment of adjacent joints, scar tissue, and other factors, certain nerves get pinched, resulting in swelling of the nerve, pain, numbness, tingling, weakness, and other symptoms.
What’s the difference between a Myofascial Trigger Point and a Nerve Entrapment?
Trigger Points (TrPs) are painful, hyperirritable muscle “knots” that can develop anywhere in the body and cause a variety of symptoms.
Nerve entrapments often occur concurrently with trigger points, may mimic the symptoms of trigger points, or may sometimes be one of the underlying causes of trigger points. Dr. Mahooti is an expert in determining whether an entrapped nerve, myofascial trigger point, combination of the two — or something else — is the cause of your symptoms.
How Are Nerve Entrapments Diagnosed?
Entrapped nerves are typically diagnosed clinically (based on your history and physical exam), and may be confirmed with one of two diagnostic tests:
- Ultrasound measurements of nerve thickness, performed by Dr. Mahooti during an office visit, to evaluate for swelling, irritation, or compression.
- Electrodiagnostic Studies (EDS), more commonly called EMG/NCS (electromyography and nerve conduction studies), evaluate how well your nerves and muscles are working together. These tests measure how efficiently nerves send signals and how muscles respond. Dr. Mahooti may refer you to a different specialist for this study.
How Are Nerve Entrapments Treated?
One of the best ways to determine if an entrapped nerve is the cause of your symptoms is to perform a minimally invasive, nearly painless procedure called a “Nerve Block / Hydrodissection” injection under ultrasound guidance. The nerve is identified with the ultraound machine, and a needle is gently advanced until it is adjacent to the nerve, and a combination of IV fluid and anesthestic is injected around the nerve to peel away the surrounding tissues that are compressing it. Cortisone is sometimes added, but typically not needed. Importantly, ultrasound guidance is used to visualize the needle and the nerve at all times, minimizing risk of nerve injury. The procedure is minimally painless (often nearly painless) that takes a few minute and is performed in the office. Sometimes the procedure needs to be repeated and/or combined with other procedures to optimize outcomes.
Is the Nerve Hydrodissection / Decompression Safe?
Yes. While all injections / procedures carry some risk, nerve hydrodissection is performed with pinpoint accuracy under ultrasound guidance. Carpal tunnel syndrome is one of many common conditions that respond well to this minimally invasive, safe, effective procedure.
What Nerves / Conditions can be Treated with Nerve Hydrodissection / Decompression?
Many pain syndromes affecting various parts of the body are caused by nerve entrapments. A few common causes include:
Shoulder / Shoulder Blade: suprascapular nerve, dorsal scapular nerve
Elbow Hand / wrist elbow: Carpal tunnel syndrome, Ulnar neuropathy, Radial neuropathy
Buttock: Cluneal nerve entrapment, sciatic nerve, posterior femoral cutaneous nerve entrapment
Thigh: Lateral Femoral Cutaneous Nerve entrapment (“Meralgia Paresthestica” — burning or tingling of one thigh)
Knee / Lower leg: Saphenous nerve / obturator nerves (tingling, burning along the inner part of the knee, often radiating down the shin); Common Peroneal Nerve (outer part of the lower leg, sometimes into the top of the foot),
Foot / Ankle: Superficial Peroneal Neuroopathy (pain, tingling, burning along the outer ankle and top of the foot), Tibial nerve (tarsal tunnel syndrome: pain, burning, tinling along the inner foot), sural nerve (posterior heel pain),