The knees are complex structures that we ask a lot of during our lifetime. They support the weight of our body and help us move through the world. We use them when lifting heavy things and climbing endless flights of stairs (or logging endless miles on the road, running). Eventually all of the pressure and movement can begin to wear on this joint, causing pain and potentially serious damage if left untreated. Sometimes knee surgery is the way to go, but sometimes that’s not an option due to other chronic conditions. Sometimes knee surgery isn’t even the best choice. Instead of more invasive surgical options, many patients turn to a genicular nerve block to treat and diagnose persistent knee pain.
What is a genicular nerve block?
A genicular nerve block is a minimally-invasive procedure used to relieve pain caused by a variety of chronic pain conditions. These can include:
- Severe osteoarthritis in the knees
- Pain due to total or partial knee replacements
- Chronic knee pain in patients who cannot have surgery
- Degenerative joint disease
The knee joint consists of just three bones: the femur, tibia, and patella (your kneecap). These three simple bones are held together by a complex network of cartilage, ligaments, and tendons. Cartilage helps to cushion and lubricate the area where bones meet. Ligaments connect the bones to each other. Tendons connect the muscles to the bones.
All of these different types of anatomy are crisscrossed and enervated by a network of femoral, common peroneal, saphenous, tibial, and obturator nerves. Each type of nerve is the relay for pain signals that originate in a different area of your knee. These nerves are broadly known as genicular nerves.
A genicular nerve block uses anesthetic injected into one or more of the genicular nerves, typically into one of three branches: the superior medial, the superior lateral, and the interior medial genicular nerves. This anesthetic interrupts pain signals being sent to the brain and can bring you tremendous relief from pain.
Genicular nerve blocks for knee pain fall under the category of selective nerve root blocks and sympathetic nerve blocks. Both of these are simply broader terminology for a pain management treatment that targets nerves to block pain signals. Sciatic nerve blocks for pain in the lumbar spine and radiating down the buttocks and legs are also a common type of nerve block.
How does a genicular nerve block help knee pain?
A genicular nerve block for knee pain can help target the area of your pain. Pain can occur anywhere in the knee joint. Injections of anesthetic can help patients experiencing pain to become or stay more active.
This is important because, often, knee pain sets off a health crisis that can steadily worsen.
A person experiencing knee pain may stop moving around as much. Not only can this cause loss of mobility in an already-sore joint, it can also cause weight gain which adds pressure to the knee. More pressure equals more pain, which in turn equals less mobility.
A genicular nerve block for knee pain can break this cycle long enough to help patients regain mobility and stay healthy.
In addition, genicular nerve blocks are also used as a diagnostic tool. Doctors can block pain signals from one area to determine what the cause of your pain might be. This is a simple way to provide more targeted and effective pain management.
In some cases, a genicular nerve block may be used in conjunction with surgical interventions to improve post-operative pain.
What should I expect during a knee genicular nerve block?
A successful genicular nerve block starts with conscientious pre-op