What is percutaneous hydrotomy?
Percutaneous hydrotomy is a superficial locoregional treatment that combines local tissue hydration with the targeted administration of selected therapeutic substances.
The technique has been used clinically for several decades, particularly in the treatment of musculoskeletal pain, osteoarthritis, persistent tendon and joint problems, chronic back pain and certain disc-related conditions.
Very fine needles are positioned superficially in the skin or immediately beneath it around the area being treated. Sterile physiological saline creates a local reservoir within the tissues. Depending on the clinical indication and treatment protocol, selected vitamins, minerals, trace elements, amino acids or other therapeutic substances can also be administered locally.
The treatment can therefore be understood through three complementary principles:
- local extracellular hydration
- targeted locoregional delivery
- micronutritional and regenerative support
The needles remain superficial. They are not inserted directly into a joint or an intervertebral disc.
For many patients, the objective goes beyond temporary symptom relief. In chronic and degenerative conditions, percutaneous hydrotomy can aim to improve the local tissue environment, support repair and recovery, improve function and, in certain spinal conditions, support disc rehydration and regenerative processes.
Clinical experience includes substantial improvements in pain, mobility and function, while structural changes have also been observed and reported clinically and radiologically.
What is percutaneous hydrotomy used for?
At Centre Algos, percutaneous hydrotomy is used primarily within the management of musculoskeletal pain and degenerative conditions.
Depending on the individual clinical picture, this can include:
- chronic low-back pain
- degenerative disc changes and disc dehydration
- certain disc protrusions and herniations
- certain forms of sciatica or radicular pain
- knee osteoarthritis
- other degenerative joint problems
- persistent tendon problems
- persistent musculoskeletal pain
The treatment is always considered in the context of the patient's symptoms, examination, existing investigations and overall treatment strategy.
Percutaneous hydrotomy can also be combined with movement and rehabilitation when clinically appropriate.
What does the evidence show?
Percutaneous hydrotomy is supported by several decades of clinical experience together with hydrotomy-specific clinical and university work and a growing body of research into closely related locoregional approaches.
A particularly relevant 2022 prospective multicentre study followed 47 people with chronic low-back pain. Average pain decreased from 7.8/10 before treatment to 3.6 at day 30 and 2.1 at day 60. Functional disability also improved substantially, with the median Quebec score decreasing from approximately 50 to 14.
A 2024 study involving 130 patients with chronic low-back pain and a 2025 review covering nine studies and more than 800 patients provide additional supporting evidence for improvements in pain and function with related superficial locoregional approaches.
Hydrotomy practice has also documented structural and radiological observations, including changes seen on follow-up imaging in certain degenerative spinal and joint conditions.
For a detailed review of clinical results, safety, scientific studies, disc rehydration, regeneration and imaging observations, read Percutaneous Hydrotomy: Effectiveness, Safety and Scientific Evidence.
Is percutaneous hydrotomy painful, and what are the potential side effects?
The very fine needles used are intended to minimise discomfort, although individual experience varies. Some people describe the sensation as barely noticeable, others as a brief sting. Because very fine needles are used, they typically leave little or no visible trace after treatment.
Reported side effects are usually local and short-lived: small bruises at the injection site, or temporary sensitivity in the treated area for a few hours afterwards. Reactions to the solution itself are described as uncommon in clinical practice. As with any injection technique, the procedure is not suitable for everyone, which is why your medical history is reviewed before a first session.
Sources & further reading
- International Association of Percutaneous Hydrotomy: scientific material, the association's own collection of clinical cases, dissertations and conference material.
- Retrospective study published by the association, useful as observational, non-randomized work.
- Percutaneous Hydrotomy in Switzerland, professional and practitioner context.
These resources provide further information on the history, professional framework and published clinical material relating to Percutaneous Hydrotomy.
Frequently asked questions
Is Percutaneous Hydrotomy the same as mesotherapy?
No. The technique developed out of mesotherapy and uses related intradermal and subcutaneous administration principles, but it is presented as a specific technique with its own protocols, refined by Dr. Guez.
How many Percutaneous Hydrotomy sessions are usually needed?
There is no universal number. It depends on the condition, how long the symptoms have been present, the area being treated and how you respond, so the plan is discussed with you individually rather than set in advance.
Is Percutaneous Hydrotomy painful?
Very fine needles are used and discomfort is generally intended to be limited, but individual experience varies. Brief local sensitivity or small bruising after a session is possible.
Where is Percutaneous Hydrotomy available in Switzerland?
Centre Algos offers Percutaneous Hydrotomy in Fribourg, Switzerland. Other practitioners in Switzerland also work with the technique; the association's practitioner listings are a starting point.
Is it right for your situation?
At Centre Algos in Fribourg, Switzerland, Percutaneous Hydrotomy is used as part of an individualized integrative approach to pain and related health concerns.
The best way to determine whether percutaneous hydrotomy has a place in your treatment plan is to review your symptoms, previous investigations and treatments together. Every situation is different, and the decision should be based on your individual clinical picture rather than a generic approach.