Jim Peters (a pseudonym) spends five days a week behind a desk, staring at a computer sometimes up to 10 hours a day. He looks forward to his 25-mile bike rides on the weekends to decompress from his brutal work schedule.
As he was riding one day, he experienced severe pain in his tailbone. Giving up his favorite activity was not an option. So he called his doctor, integrative physician Alexander Kulick.
Dr. Kulick asked Peters to give him 15 minutes for a procedure called hydrodissection, and the rest is history. Three years later, Peters is still completely pain free.
Hydrodissection frees trapped nerves using ultrasound guidance and a sophisticated injection technique to spread fluid around the nerve to free up the scar tissue that compresses nerves. Patients usually feel relief within a day.
It is a relatively new and complex technique that can save some patients from major surgery. Dr. Kulick is part of a selective group of doctors who perform this procedure.
Dr. Kulick estimates that he’s spent around 2,000 hours over the past four years learning the ins and outs of hydrodissection, especially how to recognize nerves on an ultrasound that show up as grey, undulating shapes that disappear completely from view in certain places.
“You have to know your anatomy cold,” he says. “You really need to know where things start and where things end because the only way you can be 100 percent sure that you are looking at the nerve you think you are looking at, is if it begins where it’s supposed to and it ends where it’s supposed to.”
Nerve entrapment can happen when a spasming muscle bears down on the nerve, or it can happen from a repetitive activity. “Long, frequent bike rides, like the ones Peters were doing can cause irritation and inflammation, Dr. Kulick explains.
He says that nerves can be trapped where they dive between ligaments or tendons and are compressed by chronic muscle spasms, which leads to inflammation.
“Inflammation is sticky and glues the nerve to other parts of the body. Hydrodissection allows me to take patients out of chronic pain and off drugs permanently,” Dr. Kulick says.
Before You Go for Surgery
Just about any nerve that is pinched can be freed with hydrodissection. It effectively treats carpal tunnel syndrome, tennis elbow, sciatica, herniated discs, and vulvodynia, a chronic pain condition that affects women.
Dr. Kulick says that before patients decide on surgery for any of these conditions, it’s especially important for them to get an ultrasound that specifically looks at their musculoskeletal system.
This is because while MRIs often show tears, disk abnormalities, and other problems that appear to be the cause of pain, they don’t show nerves. If pinched nerves are really the cause of your discomfort, your doctor might not realize it until after surgery.
Integrative Medicine and Pain Management
Dr. Alexander Kulick
112 E. 61st St.
New York, NY 10065
212-867-1777
DrAlexanderKulick.com
