Nine months of severe neck pain, resolved in a single procedure.

Presentation & History

The patient’s work is exacting and sedentary. As a film editor, he spends the majority of his day at a computer, head held forward and slightly rotated toward a primary monitor on his right. Over time, a dull ache on the right side of his neck became a constant, severe pain — sharp with rotation, worse by the end of each editing session, and increasingly disruptive to sleep and concentration.

He did what most patients do. He saw physicians. He underwent cervical X-rays and an MRI. Both were interpreted as normal — no disc herniation, no nerve-root compression, no fracture, no structural explanation for what he was feeling every single day. He was left with a familiar and frustrating message: the scans are clean, so the source of the pain could not be located.

A normal MRI does not mean there is nothing wrong. It means the problem is not where conventional imaging is designed to look.

The Diagnostic Problem

MRI and X-ray are built to evaluate bone, discs, and gross structural pathology. They are not designed to resolve the fine, mobile layers of fascia — the connective-tissue sheets that wrap and separate every muscle, nerve, and vessel in the neck. When fascia is injured by repetitive strain, the gliding layers can bind together into a fascial adhesion: a restricted, painful region that tethers tissue, irritates nearby structures, and refuses to resolve on its own.

These adhesions are dynamic and superficial in a way that static cross-sectional imaging routinely misses. The one modality that can see them is high-resolution diagnostic ultrasound, which images the fascial planes in real time and — critically — while the tissue moves. A growing body of work confirms that fascial layers, their abnormal stacking, and their restricted glide are visible and measurable on ultrasound when they are invisible to other modalities.^1,2,3

This is precisely the gap that Fascial Mapping® was built to close.

Fascial Mapping® Findings

At The Fascia Institute and Treatment Center® of Los Angeles, the patient underwent a comprehensive Fascial Mapping® — a systematic, ultrasound-based survey of the soft-tissue planes of the neck performed by Dr. Courseault. The examination localized a large fascial adhesion along the right lateral neck, in the region of the patient’s exact, reproducible pain. It corresponded perfectly to his posture, his hours, and his symptoms — and it was completely absent from his prior MRI and X-ray reports.

The map also did something no symptom-focused workup would have: it surveyed the whole region. In doing so, it incidentally identified thyroid nodules. Although ultimately determined to be benign, the nodules warranted appropriate further investigation — and the patient was referred for dedicated endocrine follow-up. It is a clear illustration of the value of imaging the entire field rather than only the site of complaint: the right diagnostic tool finds the problem you came in for, and occasionally one you did not know to look for.

The Intervention

The lateral neck is one of the most anatomically demanding regions in the body to treat. Within centimeters of the target adhesion lie the carotid artery, the internal jugular vein, the brachial plexus, and the cervical nerve roots. This is not a region for a blind injection or a generic dry-needling pass. It is exactly the kind of target that Hydrofascia Release™ (HFR) — the ultrasound-guided fascial hydrodissection technique developed by Dr. Courseault — was designed to address.

Under continuous, real-time ultrasound guidance, Dr. Courseault advanced a fine needle to the adhesion while visualizing every critical structure throughout. The liquid pressure of the injection itself was then used to separate the bound fascial planes — a true myofascial release performed at the source, in the same moment the fluid is delivered. The fluid does double duty: it both frees the tissue and creates a protective cushion that displaces vulnerable vessels and nerves away from the needle path. The mechanical effect of this fluid-based release on muscle and fascia has been objectively demonstrated with ultrasound elastography and in anatomical study.^4,5

The result was immediate. The patient reported substantial relief of his right-sided neck pain on the procedure table — the adhesion that nine months of imaging and treatment had failed to find was released in a single, targeted intervention.

Consolidation

Releasing an adhesion removes the cause of the pain. Consolidating that gain — restoring healthy tissue glide, calming the surrounding muscle, and rebuilding tolerance for long days at a workstation — is what keeps the pain from returning. For that, the patient completed four sessions of Human TECAR Therapy with Sarah Hallett at FIT Los Angeles.

TECAR (Transfer of Energy Capacitive and Resistive) delivers deep, controlled radiofrequency energy that stimulates circulation, accelerates tissue repair, and reduces myofascial pain. Randomized controlled trials support its role in exactly this setting — reducing pain and disability and improving range of motion in chronic non-specific neck pain and upper-trapezius myofascial pain, particularly when paired with hands-on care.^6,7,8 In this case, TECAR was the bridge from a successful release to a durable, symptom-free result.

Follow-Up

The episode changed how the patient thinks about his body. Recognizing that years of sedentary screen work had quietly eroded his health, he now stops in twice a week to train on the OxeFit at FIT Los Angeles — turning a pain crisis into a durable habit. His care has transitioned naturally from treatment into the Fascia Performance Program, which protects and builds on the gains from each procedure.

Discussion

This patient’s story turns on three things that, together, are difficult to find anywhere else.

First, the diagnosis. No modality other than high-resolution ultrasound could have identified his fascial adhesion — and no symptom-focused exam would have surveyed his thyroid. Fascial Mapping® found both. When MRI and X-ray are “normal” but pain is not, the absence of a finding is itself a clue that the search needs a better tool.

Second, the treatment. Releasing an adhesion in the lateral neck, surrounded by major vessels and nerves, demands a technique built for precision. Hydrofascia Release™ — developed by Dr. Courseault and performed under live ultrasound — uses the fluid itself both to release the tissue and to protect the structures around it. It is the deep, in-house answer to targets that surface-level modalities simply cannot reach safely.

Third, the consolidation. The release removed the cause; TECAR therapy with Sarah Hallett sealed the result, converting immediate relief into a durable, pain-free return to work. Diagnosis, release, and consolidation — each step depended on the one before it.

References & Further Reading

1. De Luca C, Sun Y, Stecco A, et al. Objective and non-invasive evaluation of fascial layers related to surgical or post-traumatic scars: a systematic review of the literature. Life (Basel). 2026;16(1):133. doi.org/10.3390/life16010133
2. Kimura H, Kobayashi T, Obata H. A conceptual fascial memory reset hypothesis: mechanobiological insights into stacking fascia as an ultrasound-visible structural phenotype and the potential role of fascial hydrorelease. Int J Mol Sci. 2026;27(9):3720. doi.org/10.3390/ijms27093720
3. Shiwaku K, Pirri C, Otsubo H, et al. Hydrorelease within the paraneural sheath: a cadaveric study. J Funct Morphol Kinesiol. 2026;11(2):199. doi.org/10.3390/jfmk11020199
4. Nakao G, Shiwaku K, Adachi R, et al. Effects of hydrorelease on the mechanical properties of muscle and fascia: a study using ultrasonic shear wave elastography. Clin Physiol Funct Imaging. 2026;46(2):e70052. doi.org/10.1111/cpf.70052
5. Ghorbanpour S, Abdi M, Naeemi N, et al. Hydrodissection with or without corticosteroid versus corticosteroid-only injection for carpal tunnel syndrome: double-blind randomized controlled trial. Muscle Nerve. 2025;71(6):986-994. doi.org/10.1002/mus.28382
6. Lytras D, Iakovidis P, Kasimis K, et al. Effects of simultaneous soft tissue mobilization and capacitive and resistive electric transfer therapy in women with chronic non-specific neck pain: a randomized clinical trial. J Back Musculoskelet Rehabil. 2025;38(6):1497-1508. doi.org/10.1177/10538127251342557
7. Bameri A, Yassin M, Salehi R, Mansour Sohani S. The effects of manual therapy with TECAR therapy on pain, disability and range of motion in women with non-specific chronic neck pain. Med J Islam Repub Iran. 2024;38:107. doi.org/10.47176/mjiri.38.107
8. Taheri P, Sadri S, Maghroori R. Effect of adding transfer energy capacitive and resistive therapy to conventional therapy for patients with myofascial pain syndrome in upper trapezius: a randomized clinical trial. J Chiropr Med. 2023;22(4):257-264. doi.org/10.1016/j.jcm.2023.07.002