A novel 2-in-1 ultrasound-guided hydrodissection for the treatment of upper back pain in the emergency department: A case series

Upper back pain is a common occurrence with a lifetime prevalence of up to 19%. Patients with refractory upper back pain can pose a unique challenge to the emergency physician. The use of ultrasound-guided regional anesthesia is an important component of multi-modal analgesia in the emergency department. Ultrasound-guided peripheral nerve hydrodissection has been shown to be an effective treatment of various nerve entrapment syndromes in the outpatient setting. We present 2 cases of patients who presented to the emergency department with refractory upper back pain failing standard therapy who were treated successfully using an ultrasound-guided combined 2–in-1 hydrodissection of the spinal accessory nerve and dorsal scapular nerve. This technique may offer a safe, rapid, and effective approach to treating patients with refractory upper back pain. Further studies would be required to assess its utility on a broader scale.