Finding a reliable treatment for post-amputation pain has been difficult, but a new study suggests that a simple procedure called hydrodissection may offer relief.
Conducted by researchers at Northwestern Medicine in collaboration with Ukrainian doctors, the study found that hydrodissection helped reduce pain and opioid dependence in amputees.
The research, published in Regional Anesthesia & Pain Medicine, is the first to explore hydrodissection as a treatment for post-amputation pain, a condition that affects millions of people worldwide.
Hydrodissection is a straightforward procedure where fluid is injected around nerves to reduce pressure, inflammation, and pain.
The process is guided by ultrasound and requires only a needle and medical expertise. While this technique has been used for other types of pain, this study is the first to examine its effect on amputees.
Dr. Steven P. Cohen, the study’s senior author and a professor at Northwestern University Feinberg School of Medicine, highlighted its benefits. “It’s remarkable how simple and accessible this technique is. Adding hydrodissection to opioid treatment not only improves pain relief but also has mental health benefits,” he said.
Cohen, a retired U.S. Army colonel, personally traveled to Ukraine to set up the study, motivated by his military background and his son’s current service in the infantry.
The study followed 74 Ukrainian soldiers and civilians who had undergone war-related amputations. Researchers divided them into two groups:
- 38 patients received hydrodissection along with opioid therapy
- 36 patients received only opioids
The results were promising. Patients who received hydrodissection reported greater pain relief, with their pain scores dropping by 4 points on a 0–10 scale, compared to a 3-point drop in the opioid-only group.
More importantly, nearly two-thirds of the hydrodissection group reduced their opioid use, while only one-third of the opioid-only group did. Those who received hydrodissection also reported less anxiety, which can be a major issue for amputees. However, the treatment’s effect on phantom limb pain and chronic pain was more limited.
Post-amputation pain is a major issue worldwide. In Ukraine alone, an estimated 100,000 people have lost limbs due to war. In the U.S., more than 2 million people live with limb loss, and this number is rising due to aging, diabetes, and vascular diseases.
“This research is highly relevant to Americans,” Cohen said. “Post-amputation pain often prevents amputees from using prosthetics and reintegrating into society. Since hydrodissection is simple, most community hospitals could easily adopt it.”
Because the study was conducted in a war zone, it was not a controlled trial, meaning further research is needed. Cohen plans to return to Ukraine this spring to conduct randomized trials on hydrodissection, as well as new treatments for post-amputation pain, PTSD, and traumatic brain injury.
He is also studying botulinum toxin injections for amputees and investigating how mental health conditions like depression and anxiety affect phantom limb pain and recovery.
If further studies confirm the benefits of hydrodissection, this simple technique could become a game-changing treatment for amputees around the world.
