Perineural injections in Vancouver.

What are perineural injections?

Perineural means around a nerve. Perineural injection therapy involves placing an injected solution near a selected peripheral nerve, rather than into the nerve itself. The solution and technique depend on the proposed treatment.

Some approaches use low-concentration dextrose, a form of glucose, around superficial sensory nerves. This differs from higher-concentration dextrose prolotherapy directed at musculoskeletal structures. The term also covers deeper procedures, so we explain exactly which approach is being discussed.

Understand the symptoms before choosing a treatment.

We review the location and pattern of symptoms, previous injuries or surgery, medications, and your examination. Burning or tingling alone does not establish a diagnosis or mean an injection is appropriate.

• Identify relevant findings. Assess sensation, strength, tenderness, movement, and possible nerve irritation or compression.
• Consider further investigation. Imaging, nerve testing, or referral may be appropriate when the diagnosis is unclear.
• Compare options. Activity changes, rehabilitation, splinting for selected conditions, medication, or specialist care may also have a role.

New or progressive weakness, persistent loss of sensation, or other changing neurological symptoms warrant timely medical assessment.

What does a perineural treatment visit involve?

We discuss the proposed target, injected solution, rationale, alternatives, and consent. Your allergy history, medications, bleeding risk, and other relevant health factors are reviewed before treatment.

Superficial perineural injections and ultrasound-guided nerve hydrodissection are different procedures. Hydrodissection uses fluid to separate a nerve from adjacent tissues under ultrasound guidance. It is not implied by every perineural injection; the specific procedure and its availability should be confirmed during assessment.

Aftercare depends on the area treated and the solution used. Follow-up considers sensation, comfort, movement, and activities that matter to you. A temporary response does not, by itself, confirm the underlying diagnosis.

Evidence, risks & realistic expectations.

Randomized studies of ultrasound-guided dextrose injections have reported benefit in selected people with mild-to-moderate carpal tunnel syndrome. Those results do not establish the same benefit for every nerve, every pain condition, or superficial injection protocols.

Evidence varies by diagnosis, technique, and injected solution. Treatment cannot be promised to repair nerve damage or permanently resolve symptoms. We agree on a reassessment point and reconsider the plan if benefit is limited.

Possible risks include temporary discomfort, bruising, bleeding, infection, symptom aggravation, and injury to nearby structures, including nerves. Additional risks depend on the solution used; local anaesthetics, when included, carry their own risks. We discuss these before deciding together.

Common questions.

Learn more.

These resources explain the approach and the evidence discussed above. Research findings are interpreted in the context of your diagnosis and care.

• Perineural dextrose for carpal tunnel syndrome · randomized controlled trial ↗
• Perineural dextrose injection volumes · randomized controlled trial ↗

Page updated November 2026.

Care with Dr. Jeff Martineau, BScH, BHSc, ND

Start with your priorities.

Care is offered at Healthcode Regenerative in Vancouver. My approach brings assessment, shared decisions, and ongoing follow-up together. Learn about my education and clinical training, or begin with a meet and greet to discuss whether the practice fits your needs.