Nerve block to combat chronic knee pain

What is a genicular nerve block?

The relatively new procedure genicular nerve block is done to treat knee pain. It is mainly done for the intractable pain of osteoarthritis where either surgery is not possible or, in some situations, when you still have severe pain after total knee replacement surgery.

What is the purpose of the nerve block?

The purpose of the genicular nerve block is to alleviate chronic knee pain and reduce the use of long-term painkillers.

How is the procedure performed?

In this procedure, some of the important nerves around the knee joint are blocked with a local anaesthetic with or without steroids, under ultrasound and X-ray guidance. You will need to come to the hospital on the day of the procedure for half a day. The actual procedure is done in the operation theatre under very sterile conditions.

Is it a painful procedure?

This procedure is done in very sterile conditions to avoid any chances of infection. It is done in an operation theatre with the patient lying on their back. The affected knee is then thoroughly cleaned just like when you have your operation. After that, under the X-ray guidance, local anaesthetic injections are given around the knee - generally in three places. This makes the entrance of the block need much less painful. Three block needles are then placed around the knee and local anaesthetic sometimes mixed with steroid is then given. Sometimes this can be little uncomfortable. After finishing this procedure you are then able to walk on your own. You may also feel the pain relief almost within few minutes.

What are the risks of a nerve block?

The risks of the genicular nerve block pain relief procedure may include:

• bruising
• Temporary increase in pain around the area.
• Infection, for which sometime you may be given antibiotics.
• Very small chances of bleeding.
• In some rare cases, there may not be the expected pain relief.

How long does it take for the procedure to work?

This procedure takes around half an hour for one knee on the day and can provide pain relief for few days to few weeks. After establishing that these test blocks are successful, another procedure is done which is called a nerve ablation, that uses heat with a specialist machine. This procedure can give long-term pain relief lasting for many weeks and it is performed on another day, again in the operation theatre in sterile conditions.