Whenever someone comes to The How Clinic with pain in the elbow the big question we always ask is “what is the pain generator”, meaning what is the thing that is actually causing the pain. So many things can cause pain and many of them can present very similarly. Figuring this out starts with listening to your story. When did it start? what makes it worse? What makes it better? Where exactly is the pain? We then do a focused ultrasound and physical exam to get the best idea of what is going on. It is a torn ligament? Is it an arthritic joint? Is there a fluid collection where there shouldn’t be? Is there a nerve that is pinched? Once we get a good idea of what is actually causing your pain we then come up with a treatment plan that uses as many of the different tools and techniques available as we need to get you out of pain as fast and safely as we can.
One of the techniques that I find extremely useful for many cases is hydrodissection. In a normal body, structures can glide across and around the neighboring structures as the body moves. Nerves slide past ligament, around muscles and through connective tissue tunnels. Over time with injury, poor posture or dysfunctional movement patterns things can get stuck or pinched. This results in pain, tightness, limitations of movement and often worsening movement patterns. An example would be that when one of your knees hurts you start favoring the bad leg and then your hip or low back can start giving you grief. One thing leads to another and you end up feeling like your body is falling apart!
Hydrodissection is a minimally invasive surgical technique that is increasingly being used to treat pain in the elbow. This technique involves injecting a solution of saline and anesthetic into the affected area to separate the tissue layers around the elbow, which can help alleviate pain and promote healing. In this blog, we’ll explore hydrodissection in more detail as it applies to the elbow, including how it works, some of the conditions it can treat, and what patients can expect during the procedure.
How Hydrodissection Works for the Elbow:
Hydrodissection works by separating the tissue layers in the affected area around the elbow joint, which can help alleviate pain and promote healing. To do this, a solution of saline and anesthetic is injected into the tissue planes around the elbow using a needle or catheter. The solution is carefully injected into the tissue layers, which helps to create space between the layers. This separation can break up adhesions and help to relieve pressure on the affected nerves or tissues, which in turn can help alleviate pain and other symptoms.
Some Conditions Treated by Hydrodissection for the Elbow:
- Tennis elbow: Hydrodissection can be used to separate the extensor tendons (the places where the muscles of your forearm attach to the outside of your elbow) from the overlying tissue and alleviate pain.
- Golfer’s elbow: Hydrodissection can be used to separate the flexor tendons (the places where the muscles of your forearm attach to the inside of your elbow) from the overlying tissue and alleviate pain.
- Ulnar nerve entrapment: Hydrodissection can be used to relieve pressure on the ulnar nerve (your funny bone), which can help alleviate pain, tingling, and numbness associated with this condition.
- Radial nerve entrapment: Hydrodissection can be used to relieve pressure on the radial nerve, which can help alleviate pain, tingling, and numbness associated with this condition.
What to Expect During the Procedure for the Elbow
During the procedure, the solution of saline and anesthetic will be carefully injected into the tissue planes around the elbow using a needle under ultrasound guidance so we can see exactly where the fluid is going.
After the injection, you may experience some temporary swelling and soreness in the affected area. However, this should gradually subside over the next few days.
Recovery After Hydrodissection for the Elbow
After hydrodissection, you may need to limit use of the elbow for a day or two to allow the affected area to heal. You are encouraged to use the area to help promote return of normal function of the structures in the area.
Here at The How Clinic, it is common for hydrodissection to significantly improve your symptoms but often the best outcomes come from having you undergo targeted medical massage, and acupuncture in the days following the hydrodissection. Additionally, we will often work with trusted physical therapists in our local area to co-manage your condition. Either way the goal is to help restore mobility and function in the affected elbow joint.