A recent study from Northwestern Medicine, in collaboration with Ukrainian physicians, suggests that hydrodissection may be an effective treatment for post-amputation pain. This procedure involves injecting fluid around nerves and could potentially reduce both residual limb pain and opioid dependence.
The study is pioneering in its evaluation of hydrodissection for post-amputation pain, a condition affecting millions globally. It was published on February 19 in the journal Regional Anesthesia & Pain Medicine.
Dr. Steven P. Cohen, senior author of the study and a professor at Northwestern University Feinberg School of Medicine, stated, "Adding hydrodissection to opioid treatment for post-amputation pain not only appears to improve pain outcomes but also shows mental-health benefits." Dr. Cohen, who is also a retired U.S. Army colonel, emphasized the importance of finding safer alternatives to opioids for young veterans at high risk of dependence due to psychological trauma.
The research involved 74 Ukrainian soldiers and civilians who had undergone traumatic limb amputations from war injuries. Participants were divided into two groups: one received hydrodissection alongside opioid therapy, while the other received only opioids. Results indicated that those receiving hydrodissection experienced better pain relief and reduced opioid use compared to the opioid-only group.
On a 0–10 pain scale, the hydrodissection group reported an average reduction of four points versus three points in the opioid-only group—a difference considered clinically meaningful. Additionally, nearly two-thirds of patients in the hydrodissection group decreased their opioid use compared to about one-third in the other group.
Cohen highlighted that this research is particularly relevant to Americans as trauma is a leading cause of upper-extremity amputations worldwide. In the U.S., over two million people live with limb loss—a number expected to rise due to aging populations and increasing rates of diabetes and vascular disease.
Hydrodissection is described as an ultrasound-guided procedure where fluid is injected into scar tissues around nerves to relieve pressure and promote healing. While promising for acute and neuropathic pain, its specific effectiveness for post-amputation pain had not been studied before this research.
"It's remarkable how simple and accessible this technique is—requiring just an ultrasound and a needle," said Cohen.
Despite conducting research during wartime conditions in Ukraine, Cohen plans to return there this spring for new trials focused on treatments for post-amputation pain, traumatic brain injury, and PTSD.
Other authors involved in the study include Dr. Dmytro Dmytriiev, Winnie L. Liu, Dr. Maksym Barsa, Dr. Andreii Khomenko, Dr. Andreii Strokan, and Dr. Paul F. Pasquina. The research received partial support from the U.S Department of Defense and Uniformed Services University.