Genicular Nerve Block

Chronic chronic pain can stop you in your tracks. Our knees are essential for everyday activities including standing, walking and sitting, so when pain is felt from this weight-bearing joint, our quality of life suffers dramatically. If rest and physical therapy haven’t been able to resolve the feelings of pain, it might be time to take advantage of the benefits of a genicular nerve block. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas are experts in treating all causes of chronic pain and can help to finally provide much needed relief. 

What is a Genicular Nerve Block?

First, it’s important to understand where the genicular nerves are located. The knee is a large, complex and weight-bearing joint that helps us to move. Without our knees we wouldn’t be able to perform even the simplest of motions! 

Looking at the makeup of the knee, there are the four main bones, which include the femur, tibia, fibula and patella. The quadriceps, calves and hamstrings help to stabilize the muscles and aid in mobility. On top of that, there are also the tendons and ligaments that connect the muscles to the bones, and include the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). These help the knee to comfortably flex and extend. 

There are also the medial and lateral ligaments that keep the knee aligned and the lateral and medial meniscus tissue that aids in movement, as well as bursae (fluid-filled sacs) that cushion the knee and prevent any of the bones from rubbing against each other. 

Genicular nerve blocks are a great diagnostic tool as well as a treatment option. Since the knee joint houses an intricate network of nerves and arteries, pain management specialists use genicular nerve blocks to determine that the patient’s source of pain is, in fact, from the genicular nerves. If the patient experiences pain relief after an injection, they might be a candidate for more permanent and long-term solutions, such as radiofrequency ablation, which is a procedure that burns or ablates the nerve to stop pain signals from being sent to the brain. 

If the provider has determined that the pain is originating from the genicular nerves in the knee, a genicular nerve block is a minimally-invasive treatment option that helps patients to experience immediate pain relief. The injection provides targeted pain relief and can help with both sporadic pain or constant pain. Additionally, genicular nerve blocks can provide pain relief for patients who have undergone knee surgery, allowing for the patient to comfortably rehabilitate and recover without having to rely on pain medications. 

How Does a Genicular Nerve Block Work?

A genicular nerve block temporarily blocks the nerve signals in the knee. It is a targeted approach, meaning that the injection is placed directly in the area of the knee where the patient is experiencing pain. It’s important to note that genicular nerve blocks do not treat the underlying cause of pain, but are a great tool as part of a comprehensive treatment approach that allows the patient to utilize other therapy methods without the feelings of pain. 

The injection is an anesthetic that works to numb the affected nerves and prevent them from sending a pain signal to the brain. Sometimes a corticosteroid can also be used to combat inflammation, but it’s not always necessary. 

What are the Benefits of Genicular Nerve Blocks? 

Genicular nerve blocks are safe and effective treatment options for patients who are dealing with chronic pain or post-operative chronic pain. Their main benefits include: 

• As a minimally-invasive treatment option, genicular nerve blocks provide patients with immediate pain relief with very little side effects or complications. They can be used as part of a treatment plan that involves physical therapy and exercise so the patient can enjoy these additional methods pain free. 
• If other conservative methods haven’t provided the needed pain relief for the patient, and the patient wants to avoid surgical options as long as possible or is not a candidate for surgery, genicular nerve blocks can provide much-needed temporary relief. 
• Due to the fact that the injection is effective with only an anesthetic, genicular nerve blocks are a good option for patients who are allergic to steroids or who want to avoid the side effects of steroid medication. 

There are also condition-specific benefits of genicular nerve blocks, such as: 

• Osteoarthritis: genicular nerve blocks have proven to provide temporary pain relief for osteoarthritis, which is one of the most common – and most difficult to treat – causes of chronic pain. Patients who were able to find relief might be good candidates for radiofrequency ablation, which provide a more long-term pain relief solution. 
• Chronic chronic pain: in addition to osteoarthritis, there are a variety of other conditions that can cause chronic pain, including gout, tendonitis and a traumatic injury. Genicular nerve blocks allow for the patient to experience immediate pain relief while other treatment options are being utilized. 
• Failed knee replacement: in the event that a patient’s partial or full knee replacement fails, possibly due to an implant that has become loose, causing swelling and pain, genicular nerve blocks can mitigate the feelings of pain while a revision surgery is performed or another option is considered. 
• Post-surgical pain management: genicular nerve blocks are an effective post-surgical pain management tool that not only helps to speed recovery but also helps patients reduce their need for oral medications. 

What Happens During a Genicular Nerve Block Procedure?

A genicular nerve block is performed in your doctor’s office with a local anesthetic. The patient is comfortably situated on the exam and the skin above and around the knee will be sterilized with a numbing medication applied. The provider will use X-ray guidance to accurately place the injections. For best results, the medication will be injected into three different locations: above the knee, on both sides of the knee, and below the knee on the inside of the leg. A main difference between genicular nerve blocks and other knee joint injections is that the nerve block medication is placed outside of the joint, targeting the genicular nerves that are the source of pain. 

The entire procedure takes about 30 minutes and most patients experience immediate pain relief. Patients are advised to rest for the remainder of the day and avoid any strenuous activity. It’s also important to take note of how long pain relief is felt. Pain relief varies from person to person and could last for days, weeks or even months. 

Risks are rare, but can include nerve damage, tissue damage, increase of pain, heavy bleeding and adverse reactions to the anesthetic. It’s important to call your doctor immediately if you experience any swelling or oozing at the knee, fever, or don’t feel well. 

If you are suffering from chronic pain and would like to know if you could benefit from a genicular nerve block, please schedule an appointment today with the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas.