Percutaneous hydrotomy relies on subcutaneous injections of solutions containing vitamins, minerals, and other micronutrients. This technique, used particularly against osteoarthritis and chronic pain, has gained visibility in recent years among patients in therapeutic dead ends. Finding a trained practitioner in France today involves navigating a path fraught with regulatory obstacles and fragmented information.
Why lists of practitioners in percutaneous hydrotomy have disappeared
The National Council of the Order of Physicians has classified percutaneous hydrotomy as a “new unproven technique” in a decision dated June 27, 2023. The National Council of the Order of Nurses has taken a similar stance, sanctioning several healthcare professionals who practiced it.
The International Association of Percutaneous Hydrotomy (AIHP) was then forced to remove the list of practitioners from its website. Dr. Bernard Guez, who presides over the association, publicly expressed his regrets about this situation, deeming it very detrimental to patients.
To identify practitioners in percutaneous hydrotomy in France, one must now rely on indirect channels, as official directories have been emptied of their content under ordinal pressure.
However, the AIHP specifies that a request for evaluation of the technique has been submitted to the Ministry of Health. As long as this evaluation has not concluded, the public dissemination of practitioners’ contact details remains suspended on the institutional websites of the discipline.
Council of State decision of October 2024: what has changed for nurses
On October 10, 2024, the Council of State annulled the decision of May 11, 2023, by the national disciplinary chamber of the order of nurses. The reason given is procedural: the disciplinary chamber had issued an injunction to the CNOI that exceeded its powers.
This annulment does not equate to recognition of the practice. It invalidates the procedure, not the debate on the therapeutic substance. Nurses who were subject to disciplinary action have, however, obtained a legal precedent to rely on.
Field feedback varies on the concrete impact of this decision. Some nurses have resumed their activities, while others are still waiting for a clearer framework. Uncertainty particularly surrounds insurance coverage: healthcare professionals have a legal obligation to take out professional liability insurance, and some insurers hesitate to cover a technique whose regulatory status remains unclear.
Networks of practitioners and mentorship: how the offer is still structured
Despite the withdrawal of public directories, networks of practitioners continue to operate in France. In Bouches-du-Rhône, a nursing association updated in August 2026 has a clear goal: to unite nurses practicing percutaneous hydrotomy at the national and international levels.
The structuring mechanisms operate through several channels:
- Mentorship, where an experienced practitioner supervises a newcomer during their first sessions, thus forming a gradual local network
- Training courses and workshops organized outside traditional university circuits, often lasting several days and including supervised practical components
- Private groups on social networks and patient forums, where word-of-mouth recommendations circulate
The mapping of practitioners is continuously evolving and no longer corresponds to the fixed lists that circulated before 2023. An old document hosted on Scribd lists doctors and nurses trained in the northwest of France, but this information dates back to before the ordinal sanctions and may be outdated.
Directories of complementary medicine
Some platforms like Resalib list practitioners under the label “hydrotomy” or related specialties (naturopathy, mesotherapy). These directories allow users to consult reviews, prices, and make appointments online. Their geographical coverage remains uneven, concentrated in urban or peri-urban areas.
Mesotherapy and percutaneous hydrotomy share a common technical foundation (subcutaneous injections of therapeutic solutions), which explains why some mesotherapy practitioners also master the second technique without explicitly stating it.
Necessary checks before consulting a practitioner
The fact that a practitioner offers percutaneous hydrotomy does not exempt one from verifying several concrete elements before any consultation.
- The practitioner must be registered with the corresponding professional order (doctors or nurses), which guarantees a minimum of disciplinary traceability
- Professional liability insurance must explicitly cover the technique practiced, not just the general activity of the professional
- A prior medical consultation with a referring physician in percutaneous hydrotomy is mandatory before any care is provided by a nurse, according to the AIHP protocol
- Signatories of the Quality Charter and good practice of the SIHP offer an additional level of commitment, identifiable by an asterisk on the old lists of practitioners
The absence of a clear regulatory framework makes patient vigilance all the more necessary. The CERFA testimonies collected by the AIHP, accompanied by a petition gathering nearly 3,000 patients, document perceived benefits, but no institutional evaluation has yet validated the technique scientifically.
Percutaneous hydrotomy abroad: an alternative for French patients
The AIHP offers a contact form on its website dedicated to individuals seeking a practitioner outside of France. This option is for patients who cannot find a local professional or who prefer to consult in a country where the practice is not subject to the same ordinal restrictions.
The available data does not allow for a precise mapping of the countries where the technique is recognized or regulated. The legal framework varies from country to country, and patients considering this option must verify the validity of the practitioner’s qualifications, the conditions of care, and the coverage of their own health insurance abroad.
The situation in France remains in limbo. Between the partial annulment of sanctions by the Council of State and the request for evaluation submitted to the Ministry of Health, the coming months will determine whether percutaneous hydrotomy gains a clearer status, or if patients will have to continue navigating between informal networks and associative initiatives to access this technique.
