Nerve entrapment.
Localize before you treat.
Numbness, tingling, burning, weakness, and radiating pain can come from the spine, plexus, or peripheral nerve. The first job is to determine where along that pathway the problem actually is.
A nerve symptom does not tell you where the nerve is injured
Peripheral nerve evaluation combines symptom distribution, strength, reflexes, provocative maneuvers, sensory testing, and when useful, electrodiagnostic testing and ultrasound.
Ultrasound can show nerve enlargement, flattening, altered fascicular appearance, dynamic compression, adjacent masses, and the relationship between the nerve and surrounding tissue.
Entrapment can occur at predictable anatomic tunnels
Carpal tunnel
Median nerve compression at the wrist can be assessed clinically and with ultrasound, often alongside nerve-conduction testing.
Cubital tunnel
Dynamic ultrasound can help assess nerve subluxation and focal changes around the elbow.
Focal entrapments
Superficial radial, common fibular, tibial, and other peripheral nerves can be evaluated when symptoms fit the anatomy.
Ultrasound adds anatomy to the neurologic examination.
It can be especially useful when the question is not only whether a nerve is abnormal, but where and why.
A procedure for selected focal entrapments
Ultrasound-guided nerve hydrodissection is used in selected cases to separate a nerve from adjacent tissue and deliver fluid around the nerve under direct visualization. It is not appropriate for every neuropathy or every degree of compression.
Go deeper on the decision-making.
What patients usually want to know.
Can ultrasound diagnose carpal tunnel syndrome?
Ultrasound can identify structural changes of the median nerve and is useful alongside the history and examination. Electrodiagnostic testing may still be appropriate depending on severity and the clinical question.
What is nerve hydrodissection?
Hydrodissection is an ultrasound-guided procedure in which fluid is placed around a peripheral nerve to separate it from adjacent tissue. It is used selectively after the nerve problem is localized.
When is surgery better than hydrodissection?
Progressive weakness, significant denervation, severe compression, a mass lesion, or failure of appropriate nonsurgical care may make surgical decompression the better option.
Can a pinched nerve in the neck mimic carpal tunnel?
Yes. Cervical radiculopathy, proximal median nerve problems, and other neurologic conditions can overlap with hand numbness, which is why localization matters before treatment.
This page is educational and does not establish a physician-patient relationship. Individual treatment recommendations require an in-person clinical evaluation.