Carpal Tunnel and Pinched Nerve Treatment Without Starting With Surgery
Numb fingers at night, tingling that runs down your arm, a grip that keeps dropping things. When a nerve gets squeezed or stuck, Dr. Spiegel tests it here in the office, then uses ultrasound to free it with a gentle injection of fluid called hydrodissection.
Not ready to book? Start with a free 15-minute call
What Is Nerve Hydrodissection?
Nerves run through tight spaces, like the carpal tunnel in your wrist. When the tissue around a nerve swells or scars, the nerve gets pinched or stuck, and you feel numbness, tingling, burning or weakness. In hydrodissection, Dr. Spiegel watches the nerve on ultrasound and injects fluid around it to gently separate it from the tissue pinning it down. It's done in the office, with no incision and no stitches.
How Do We Treat a Pinched Nerve?
First we find exactly which nerve is trapped and where. Then we free it.
Test the Nerve
EMG and nerve conduction testing here in the office shows which nerve is involved and how much it is affected.
See It on Ultrasound
Ultrasound shows the nerve and the tissue around it, so Dr. Spiegel can see where it is pinched.
Hydrodissection
Fluid is injected around the nerve under ultrasound to free it. The area is numbed first and it takes a few minutes.
Request a visitSupport the Healing
Splinting, movement changes and hands-on care help keep pressure off the nerve.
Osteopathic care ยท Perineural injection therapyEvery hydrodissection is ultrasound guided. Dr. Spiegel watches the needle and the nerve on screen the whole time, so the fluid goes around the nerve, not into it.
Could Hydrodissection Help Your Nerve Pain?
It works best when a nerve is pinched but not badly damaged. Testing tells us which group you are in.
Often a Good Fit
- Numbness or tingling in your fingers, often worse at night
- Mild to moderate carpal tunnel on testing
- A steroid shot or splint helped for a while, then stopped working
- Ulnar nerve symptoms at the elbow, like a numb ring and pinky finger
- You want to try something before surgery
May Need a Surgeon
- Constant numbness that never lets up
- The thumb muscle at the base of your hand is shrinking
- Testing shows severe nerve damage or weakness that keeps getting worse
Already had carpal tunnel surgery and still have symptoms? That is common, and scar tissue around the nerve can be part of it. Ask us about it.
What Does Recovery Look Like?
Most people go back to light use of the hand or arm the same day. The numbing wears off in a few hours, and the area can be sore for a day or two.
Some people need more than one session, a few weeks apart. Dr. Spiegel will tell you what to expect based on your testing.
Light use of the hand, numbing wears off
Mild soreness where the needle went in
Many people notice less tingling and better sleep
Recheck, and a repeat session if needed
Who Is Dr. Spiegel?
Dr. Neil Spiegel, DO, MBA is an osteopathic physician and a diplomate of the American Board of Electrodiagnostic Medicine, so he can test your nerves and treat them in the same office. He uses ultrasound for every nerve injection and looks at your neck, shoulder and posture too, since a nerve can be squeezed in more than one place.
What Do People Ask About Carpal Tunnel and Hydrodissection?
Does Hydrodissection Work for Carpal Tunnel?
The research is encouraging. A 2024 review covering 923 patients found it eased nerve pain, and side effects were rare. It is most often used for mild to moderate cases.
What Is Injected?
A fluid such as sterile saline or a dextrose solution, sometimes with a numbing medicine. Dr. Spiegel picks what fits your case.
Does It Hurt?
The skin is numbed first. Most people feel pressure, and some feel a brief tingle as the fluid moves around the nerve.
How Many Sessions Will I Need?
Some people need one, others need a short series a few weeks apart. It depends on how long the nerve has been pinched and what testing shows.
Do I Need an MRI First?
Not always. Dr. Spiegel starts with an exam, nerve testing and ultrasound here in the office. If those don't tell the whole story, he'll order an MRI or other diagnostic testing, or refer you to get it.
Is It Covered by Insurance?
We don't bill insurance, but we'll give you a claim form if you have out-of-network benefits.
Request an Appointment
Tell us where the numbness or tingling is, and our team will reach out to schedule your visit with Dr. Spiegel.
Get the Feeling Back in Your Hands
Book a visit with Dr. Spiegel in Rockville, MD.
Not ready to book? Start with a free 15-minute call