At Bozeman Sports Medicine, we offer many advanced medical treatments to help you recover in record time in the least invasive way.
Nerves are injured by a variety of mechanisms, but nerve entrapments are the most common. Nerves can become entrapped within tunnels through which they travel (examples being carpal tunnel, cubital tunnel, fibular tunnel), within bony passageways (spine), or in scar tissue within fascia (greater occipital nerve, spinal accessory nerve). Nerves become painful when entrapped, either because of direct compression or by tension exerted on the nerve when we move our body.
Some of the most complicated and unusual cases turn out to be nerve entrapments. Nerve entrapments are easily mistaken for injuries to the musculoskeletal system (muscles, tendons, bones, joints, fascia, ligaments), especially if the only symptom is pain. Thus, many of our patients with nerve entrapments have suffered from their condition for an extended time, with failed treatment. The most useful tool for the diagnosis of entrapment of peripheral nerves, other than a detailed understanding of the anatomy of the nervous system, is ultrasound. Being able to directly visualize the nerve and assess its appearance has for the most part replaced needle electrode studies of nerve function. Needle electrode studies are painful, and doctors who perform them have long waiting lists. Ultrasound is a quicker route to diagnosis, more comfortable, and has strong evidence.
The treatment of nerve entrapments depends on which nerve and exactly how it is entrapped. Entrapment in fascia benefits from ultrasound-guided hydrodissection, in which injected liquid (PRP, or a local anesthetic, or saline, depending on how unhealthy the nerve looks by ultrasound) peels the fascia away from the nerve. The needle never touches the nerve as it’s done under ultrasound guidance; it is the jet of liquid from the needle tip that does the work. This method clearly requires good ultrasound guidance and is a major part of our skillset at Bozeman Sports Medicine.
There are mechanisms of nerve entrapment other than scar tissue in fascia, and if you have one of these, you can trust that we will explain it thoroughly to you.
A non-invasive way of getting your body’s healing mechanisms to work for you so you can get back to living the life you love.
Injuries to tendons, ligaments, joints and nerves are best treated by utilizing your body’s own cells to direct the healing process. Surgery is no longer the gold standard. In chronic injuries, these healing cells are not present at the injury site any longer. Using ultrasound guidance, we are able to deliver them precisely to where they need to be. These treatments have allowed our patients to return to their full potential and back to living their best life.