Advanced Fascial Procedures — The Fascia Institute and Treatment Center®

Hydrofascia Release™

An ultrasound-guided fascial injection procedure that targets the root cause of chronic pain — in the neck, back, shoulders, hips, and beyond — without surgery and with minimal downtime

Dr. Jacques Courseault, MD | Tulane University School of Medicine | The Fascia Institute and Treatment Center®, New Orleans, LA

What Is Hydrofascia Release™?

When Fascia Is the Source of Your Pain, Treating Fascia Is the Solution

Fascia is the continuous web of connective tissue that surrounds and connects every structure in your body — muscles, nerves, joints, organs, and skin. It is one of the most densely innervated tissues in the body. When fascia is healthy, it glides freely and transmits force efficiently. When it becomes restricted — through injury, overuse, surgery, repetitive strain, or inflammation — it thickens, adheres, and compresses the structures around it. The result is pain that is often chronic, difficult to localize, and poorly explained by standard imaging like X-ray or MRI.

Hydrofascia Release™ is the signature fascial injection procedure developed and performed at The Fascia Institute and Treatment Center®. Under continuous high-resolution ultrasound guidance, Dr. Courseault introduces a precise volume of fluid directly into restricted fascial planes, hydraulically separating the layers and restoring the gliding motion that healthy fascia is designed to provide. The procedure requires exceptional anatomical expertise and real-time imaging skill — and it is producing outcomes in conditions where conventional treatment has often failed.

The video below shows Hydrofascia Release™ being performed on the lower back — one of the most common and most treatable areas of fascial restriction. Watch as the fluid creates visible separation between planes that had been densely adherent, restoring the mobility the tissue lost.

Live Procedure — Hydrofascia Release™ of the Lower Back

Conditions We Treat

Fascial Restriction Is Behind More Conditions Than You May Realize

Because fascia is everywhere in the body, fascial dysfunction can be the hidden driver of pain in virtually any region. The following are among the most common conditions successfully treated with Hydrofascia Release™ at The Fascia Institute.

Migraines & Headaches

Fascial restriction in the cervical spine, suboccipital region, and upper trapezius is a frequently overlooked driver of chronic migraine and tension headache. Hydrofascia Release™ of these planes can reduce headache frequency and intensity significantly — especially in patients whose migraines have a strong postural or cervicogenic component.

Low Back Pain

The thoracolumbar fascia is one of the largest and most mechanically loaded fascial structures in the body. When it thickens and adheres, it generates deep, chronic low back pain that is often resistant to physical therapy, injections, and medication. Hydrofascia Release™ directly targets these adhesions under ultrasound visualization — see the procedure video above for a real example.

Neck Pain

Cervical fascial restriction causes neck stiffness, restricted rotation, radiating pain into the shoulders and arms, and contributes significantly to headache. When imaging shows multilayered fascial thickening in the cervical paraspinals or scalene region, Hydrofascia Release™ provides targeted relief that manual therapy and medications often cannot match.

Shoulder Pain

Fascial restriction around the shoulder — in the rotator cuff interval, the pectoralis minor, the biceps tendon sheath, and the anterior capsule — contributes to shoulder impingement, limited range of motion, and chronic pain that persists after rotator cuff treatment. Hydrofascia Release™ restores the gliding motion between these structures, reducing mechanical irritation and improving function.

Shoulder Blade Pain

Deep, aching pain along the inner edge of the shoulder blade is one of the most common and most underdiagnosed fascial pain presentations. Fascial adhesion between the trapezius and rhomboid layers — often involving the dorsal scapular nerve — creates a persistent pain pattern that is frequently misattributed to disc disease or muscle tension. Dr. Courseault has published a case series documenting successful treatment of this condition.

Rib Adhesions & Chest Wall Pain

Intercostal and costal fascial adhesions cause chest wall tightness, restricted breathing depth, rib hypomobility, and localized pain that can be mistaken for cardiac or pulmonary conditions. Post-surgical, post-traumatic, or idiopathic rib fascial restriction responds well to targeted Hydrofascia Release™, with many patients reporting improved breathing mechanics alongside pain relief.

Hamstring Pain

Chronic hamstring pain — whether from a prior strain, tendinopathy, or recurrent tightness — is frequently driven by fascial adhesion rather than ongoing muscle injury. Dr. Courseault is the first physician to describe and publish the hamstring Hydrofascia Release™ procedure, documented in a peer-reviewed publication in Current Sports Medicine Reports. Athletes who have struggled with recurrent hamstring problems often respond dramatically to this approach.

IT Band Pain

IT band syndrome — lateral thigh and knee pain that plagues runners, cyclists, and active patients — is driven by fascial thickening and adhesion along the iliotibial band, not simply friction at the knee. Standard stretching and foam rolling address the surface; Hydrofascia Release™ addresses the restricted fascial planes within and around the IT band itself, providing relief that conservative measures often cannot achieve.

Knee Pain

Patellar retinacular tightness, infrapatellar fascial adhesion, and fascial restriction around the knee joint contribute to anterior knee pain, patellar maltracking, and post-surgical stiffness. When the underlying fascial layers are not addressed, strengthening and stretching programs have a limited ceiling. Hydrofascia Release™ targets the fascial restriction directly, restoring patellar mechanics and reducing pain.

The Procedure

How Hydrofascia Release™ Works

Under high-resolution ultrasound imaging, Dr. Courseault identifies the exact fascial planes that are thickened, adherent, or restricted. What should be two distinct, freely gliding layers often appears — in areas of chronic pain — as five or six dense, immobile layers matted together. This fascial thickening is a consistent and reproducible ultrasound finding in patients with chronic musculoskeletal pain — one that standard MRI cannot detect.

A fine needle is introduced to the target plane under continuous ultrasound visualization. A precise volume of fluid is then injected, spreading hydraulically between the fascial layers and separating them — restoring the gliding mechanics the tissue lost. The procedure is performed in the office, requires no anesthesia, and typically takes 20–45 minutes depending on the number of areas treated. Most patients return to daily activities within 24–48 hours.

When a nerve is also involved — compressed or tethered within a restricted fascial plane — the same hydraulic release frees the nerve simultaneously, addressing both structural and neurological sources of pain in a single treatment. This combined approach is particularly useful for conditions like ulnar nerve entrapment at the elbow and carpal tunnel syndrome, where fascial and nerve pathology coexist.

Many patients notice improvement immediately following treatment. For conditions involving extensive or long-standing fascial restriction, a series of sessions progressively addresses the full extent of the problem and produces the most durable outcomes. Hydrofascia Release™ is best understood as a cornerstone of a broader treatment program — one that also includes movement rehabilitation to maintain and build on the gains achieved through the procedure.

Procedure Video — Nerve Release

Hydrofascia Release™ of the ulnar nerve — fascial scar tissue is released from around the nerve at the elbow. This patient reported complete resolution of hand numbness and tingling following the procedure. Published case report: JSES Reviews, Reports, and Techniques, 2023.

Published Research

Dr. Courseault’s Peer-Reviewed Work in Fascial Medicine

The techniques used at The Fascia Institute are not experimental — they are documented in peer-reviewed medical literature. Selected publications directly relevant to Hydrofascia Release™:

Safety: Why Expertise Is Non-Negotiable

Hydrofascia Release™ is safe when performed by a physician with the depth of training and procedural experience these techniques require. Working under ultrasound guidance in close proximity to nerves, blood vessels, tendons, and joints demands subspecialty-level expertise — this is not a procedure where general injection experience is sufficient.

Dr. Courseault is among the world’s pioneering specialists in fascial medicine. He is the first to describe several specific Hydrofascia Release™ approaches, has published his techniques in peer-reviewed journals, and continues to train physicians internationally. His work has been recognized in regional and national media, including a feature interview with Meg Farris of WWL-TV New Orleans.

We recommend beginning with an evaluation at The Fascia Institute and Treatment Center® to confirm candidacy, review your imaging, and develop an individualized treatment plan before any procedure is performed.

Insurance Coverage & Pricing

Initial consultation: Covered by insurance. This visit includes a full history, physical examination, and ultrasound assessment to determine whether you are a candidate.

Procedure cost: Hydrofascia Release™ is currently classified as investigational by insurance carriers. The Fascia Institute charges $500 per procedure — all-inclusive, no hidden fees.

HSA / FSA eligible. You may use Health Savings Account or Flexible Spending Account funds for this procedure.

Receipt provided for any out-of-network reimbursement submission to your insurance carrier.

Ready to Find Out If You Are a Candidate?

The first step is an evaluation with Dr. Courseault. We will review your history, assess your imaging, and determine whether Hydrofascia Release™ is right for your pain.

Make an Appointment