A New Option for Chronic Trapezius, Upper Back & Low Back Pain
A low-risk, in-office, ultrasound-guided procedure that uses injected fluid — and, when needed, the enzyme hyaluronidase — to loosen thickened, restricted fascia and free entrapped nerve branches. Developed for chronic myofascial pain syndrome — including chronic upper and lower back pain, chronic whiplash, and back stiffness — that hasn't responded to other treatments.
Personalized Case Review
Releasing Tight Fascia & Trapped Nerve Branches
In chronic myofascial pain syndrome — for example, following a whiplash injury — the fascia — the connective tissue that surrounds and separates muscles — can become thickened, restricted, and adhered, often entrapping the small nerve branches that run through it. This can drive persistent, deep, aching pain in the trapezius, upper back, and lower back that doesn't respond well to stretching, massage, or physical therapy alone.
Fascia hydrodissection uses precisely placed fluid, guided in real time by ultrasound, to mechanically separate and loosen these restricted fascial planes and free the nerve branches running through them.
What Fascia Hydrodissection Looks Like
Click any image to enlarge.
These images show an ultrasound-guided fascia hydrodissection (or hydrorelease) in the upper back. Under real-time ultrasound, fluid is delivered directly into the restricted fascial plane, separating the fascial layers to release the nerve branches that run through them.
Low Risk, Diagnostic, and Done in the Office
This procedure was developed for patients with chronic myofascial pain — including cases following a whiplash injury — that hasn't fully responded to conservative care — here's what makes it a reasonable next step.
Diagnostic & Therapeutic in One
The first procedure shows Dr. Salamatipour, in real time, exactly how tight and restricted your fascia is — confirming the diagnosis while treating it at the same time. Many patients get real relief from this step alone.
Low Risk
Performed entirely under ultrasound guidance with fluid, a local anesthetic, and, when needed, hyaluronidase — a well-studied enzyme with an established safety profile.
Done Right in the Office
No surgery, no sedation, and no downtime — the entire procedure is performed at our Newport Beach office in a single visit.
Escalated Only If Needed
Hyaluronidase is added only if the first, simpler procedure doesn't fully resolve your pain — usually 2–3 procedures total are sufficient.
100% ultrasound-guided. Every fascia hydrodissection procedure at OCMSK is performed under real-time ultrasound guidance, so the injection is delivered precisely to the restricted fascial planes and nerve branches causing your pain.
Where This Treatment Fits Into Your Care
Chronic Myofascial Pain Syndrome ›
Persistent, deep muscular pain from thickened, restricted fascia in the trapezius, upper back, and lower back — including pain that lingers after a whiplash injury.
Chronic Low Back Pain ›
Myofascial contributions to chronic low back pain that haven't responded to other treatment.
Nerve Entrapment Within Fascia ›
Nerve branches compressed or entrapped by surrounding fascia rather than at a joint or tunnel.
This list is not exhaustive. Contact us to schedule a consultation for a proper diagnosis and treatment options.
Common Questions
What is fascia hydrodissection? +
It's an ultrasound-guided injection procedure that uses fluid — and, when needed, the enzyme hyaluronidase — to mechanically loosen thickened, restricted fascia and free the small nerve branches that run through it. It's used for chronic myofascial pain syndrome affecting the trapezius, upper back, and lower back — including cases that develop after a whiplash injury.
Why is the first procedure done without hyaluronidase? +
The first procedure uses D5 (5% dextrose) and a local anesthetic. It's diagnostic — it shows exactly how tight and restricted the fascia is — and it often provides meaningful relief by itself. Hyaluronidase is only added on a second procedure if that relief is incomplete.
What is hyaluronidase and is it safe? +
Hyaluronidase is an enzyme that breaks down hyaluronic acid within tissue, helping to loosen thick, fibrotic fascia and release adhered nerve branches. It's a well-studied medication with an established safety profile and a low risk of complications when used in this way, under ultrasound guidance.
How many procedures will I need? +
Usually 2–3 procedures total are sufficient. Some patients get lasting relief from the first, diagnostic procedure alone; others benefit from adding hyaluronidase on a second procedure. We'll build a specific plan with you based on your response to treatment.
Why does ultrasound guidance matter? +
Blind injections frequently miss their target. Every fascia hydrodissection procedure at OCMSK is performed under real-time ultrasound guidance, so the fluid is delivered precisely to the restricted fascial planes and nerve branches causing your pain.
Is this covered by insurance? +
With an accepted plan (Cigna, Anthem Blue Cross, Aetna, United Healthcare, or Medicare PPO), your first fascia hydrodissection procedure is covered by your insurance. Unlike most procedures at our office, additional procedures may include a separate charge for hyaluronidase, if indicated, which is not covered by insurance — see our pricing page for details. Call us and we will walk you through the details.
What happens at the first visit? +
A full history and physical exam plus a diagnostic ultrasound of the affected area — so you leave with an accurate diagnosis, an understanding of every factor contributing to it, and a clear treatment plan.
Find Out If Fascia Hydrodissection Is Right for You
Call or email today — we'll answer your questions and schedule your consultation with Dr. Salamatipour.
Personalized Case Review400 Newport Center Dr, Suite 602-A, Newport Beach, CA 92660 · PPO insurance, Medicare PPO, & self-pay accepted