A targeted nerve block for knee pain that identifies the source of your discomfort and provides relief without surgery or joint replacement.
A Genicular Nerve Block is a minimally invasive procedure used to treat knee pain, particularly pain that arises from osteoarthritis (OA), inflammation, or other joint-related conditions. The procedure targets the genicular nerves, which are sensory nerves that provide pain sensation to the knee joint. By blocking these nerves, the procedure can provide significant pain relief. It can also serve as a diagnostic tool to identify the genicular nerves as the source of pain. For those who experience significant relief, the procedure can lead to further treatment options, such as radiofrequency ablation, for more long-term pain management.
Your knee joint is surrounded by a network of small sensory nerves called genicular nerves. These nerves do not control the muscles around your knee or affect your ability to walk or bend. Their sole purpose is to transmit pain signals from the knee joint to your brain. When your knee is affected by arthritis, injury, or chronic inflammation, these nerves can become overactive and send constant pain signals that interfere with your daily life.
A genicular nerve block works by placing a local anesthetic on three or more of these nerves around the knee, temporarily stopping them from transmitting pain. The immediate relief you feel tells your doctor that these specific nerves are responsible for your knee pain. This is especially helpful for patients who have been told they need a knee replacement but are not ready or able to undergo surgery, as well as patients who have already had a knee replacement but still experience persistent pain.
Genicular nerve blocks are recommended for patients with chronic knee pain that has not responded well to other treatments. You may be a good candidate if you have:
This procedure is particularly valuable for older adults and patients with multiple health conditions who want effective pain management without the risks and recovery time of major surgery.
The procedure is performed in an outpatient setting and typically takes about 20 to 30 minutes.
You will be positioned comfortably with the affected knee accessible. The skin around the knee is cleaned and sterilized. A local anesthetic is applied to numb the surface.
Using fluoroscopy (live X-ray) or ultrasound guidance, your doctor will guide thin needles to three or more specific locations around the knee where the genicular nerves travel close to the bone. These locations are predictable based on anatomy, and the imaging ensures the needles are placed accurately.
A small amount of local anesthetic is then injected at each nerve location. You may feel brief pressure or a mild sting at each site. The entire injection process takes just a few minutes.
After the injections, you will be asked to walk around and test your knee. The degree of pain relief you experience during this time is carefully assessed, as it determines whether genicular radiofrequency ablation would be an effective next step.
Genicular nerve blocks are covered by most insurance plans, including Medicare, when chronic knee pain from osteoarthritis or other documented conditions is present. Our office will verify your coverage and let you know about any expected costs before your procedure.
Recovery from a genicular nerve block is minimal. Most patients can walk out of the office and resume normal activities the same day.
You may notice immediate relief in your knee from the local anesthetic, which typically lasts several hours. Pay close attention to how your knee feels during this time, as your doctor will want to know the percentage of pain relief you experienced.
Mild soreness at the injection sites is common and usually resolves within a day. Ice can be applied as needed. There are no significant activity restrictions, though you may want to take it easy for the rest of the day.
The primary value of a genicular nerve block is diagnostic. If you experience significant relief (typically 80% or more) while the anesthetic is active, it confirms that the genicular nerves are the source of your knee pain and that you are a strong candidate for genicular radiofrequency ablation.
Some patients also get therapeutic benefit from the block itself, especially if a steroid is included. Relief from a single block can last days to weeks. However, for most patients, the real goal is to use the diagnostic information to move forward with RFA, which provides much longer-lasting results.
Here is what to keep in mind before your genicular nerve block:
Medications: Let your doctor know about all medications, including blood thinners and anti-inflammatory drugs. Most patients do not need to stop medications for this procedure, but your doctor will advise you.
Pain tracking: You will be asked to carefully evaluate your knee pain before, during, and after the procedure. Bring a mental note of your typical pain level so you can compare.
Transportation: You may be able to drive yourself, but having a driver is recommended in case the numbing affects how your leg feels temporarily.
Expectations: This block often serves as a stepping stone to radiofrequency ablation. Even if the relief is temporary, a positive response is a very good sign for long-term treatment.
Allergies: Inform your doctor of any allergies to local anesthetics or contrast dye.
Chronic knee OA pain that has not responded to medications, therapy, or standard injections can be effectively managed by targeting the nerves that carry pain signals from the joint.
Some patients continue to experience pain even after a total or partial knee replacement. A genicular nerve block can identify and treat the nerve-related component of that persistent pain.
For patients who are not candidates for knee replacement or want to delay surgery, genicular nerve blocks and the RFA that follows offer a way to manage pain and maintain function without a major operation.
The genicular nerves only carry pain signals. They do not control any muscles or movement in your leg. Blocking or ablating them does not affect your ability to walk, bend, or use your knee normally.
