What is a genicular nerve block?
Genicular refers to the Latin word for knee, “geniculum.” You may develop chronic pain in the knee for a variety of conditions, and the nerves that supply the knee may be the generator of that pain. A genicular nerve block is a diagnostic procedure to determine if the pathologic changes and inflammation within the knee joint is the source of your knee pain. It temporarily turns off the pain sensation in the nerves of the knee and helps determine the long-term pain management treatment.
How is the procedure performed?
The most common nerves targeted with this procedure are the superior medial, the superior lateral, and the interior medial genicular nerve roots. The nerves targeted for your specific injection are identified after a thorough physical examination and review of imaging studies. The procedure is done with the administration of local anesthetic to numb the injection site and is done with the guidance of a fluoroscope so that the needle is placed in the exact location necessary.
What conditions are treated with a genicular nerve block?
The conditions most commonly treated with a genicular nerve block include severe osteoarthritis, severe knee pain, chronic knee pain, and degenerative joint disease of the knee.
How should I prepare for the injection?
If you need something to help with anxiety related to the procedure, you should discuss this with Dr. Irwin. Receiving a pre-procedure medication can help reduce the anxiety. If you are taking any blood pressure medication, you should not skip any regular dose of this medication. However, if you are taking any medications that might thin your blood, you should discuss this with Dr. Irwin to make sure we have approval from your Cardiologist to hold this medication for the appropriate number of days prior to the injection.
On the day of your injection, you should have nothing to eat or drink for two hours prior to the injection. You should have someone who can drive you home from the procedure. You should not return to work the day of your procedure. You can safely resume your normal activity the day after your injection.
What should I expect after my injection?
The local anesthetic might start helping the day of the injection, and we will send you home with a pain diary to document your pain over the next 24 hours. We track what whether the pain goes away and you are better able to tolerate the activities that cause your pain. If you experience relief of more than 50% of your pain, then we discuss your candidacy for radiofrequency ablation.
How often should I have the injection repeated?
The genicular nerve block is usually a diagnostic procedure. We only expect you to feel pain relief for a couple of days at the most. Some patients benefit from a second injection, but the goal is to find a treatment with more permanent benefits.
Are there things I should look for after having this procedure?
Of course, you can call our office with any questions you might have. There are certain “red flag” warnings that you should call us about, or if it is after clinic hours you should go to your nearest ER. These would include severe or worsening pain, fever over 101, new or worsening weakness, injection site redness or drainage.