A genicular nerve block is a targeted, image-guided injection that numbs the small sensory nerves around the knee to help diagnose and temporarily relieve chronic knee pain, most often from osteoarthritis.
OVERVIEW
What a genicular nerve block is and how it works
The knee is supplied by a network of small sensory branches called the genicular nerves, which carry pain signals from the joint toward the brain. A genicular nerve block delivers a small amount of local anesthetic (sometimes combined with a corticosteroid) precisely around these nerves to interrupt those signals before they reach you.
The procedure serves two purposes. As a diagnostic test, it helps confirm that the genicular nerves are carrying your knee pain. If you experience meaningful relief after the block, you are more likely to benefit from genicular radiofrequency ablation, a longer-lasting treatment that uses heat to interrupt the same nerves. As a therapeutic step, the anesthetic and any steroid can provide a period of pain relief on their own. Because relief from a local anesthetic is inherently temporary, the block is most often used as the diagnostic step before ablation.
It is a minimally invasive, non-surgical option performed on an outpatient basis and does not require general anesthesia. Our fellowship-trained physicians in Gresham and Portland, Oregon use this approach for patients who have not found adequate relief from oral medications, physical therapy, or joint injections.
CONDITIONS
What a genicular nerve block treats
Genicular nerve blocks are used primarily for chronic knee pain when other conservative measures have fallen short.
Commonly treats
YOUR VISIT
What to expect
Before
Your physician will review your history, imaging, and medications. Tell us about blood thinners, as these may need to be adjusted beforehand. Because no general anesthesia is used, most patients can eat normally and only need to arrange a ride home if sedation is planned.
During
You lie on your back with the knee slightly supported. After the skin is cleaned and numbed, your physician uses live X-ray (fluoroscopy) or ultrasound guidance to position a thin needle near each target genicular nerve. A small volume of anesthetic, with or without steroid, is then injected. The procedure itself typically takes about 15 to 30 minutes.
After
You rest briefly, then go home the same day. Many patients are asked to keep a simple pain diary over the following hours, because how much the knee improves while the anesthetic is active helps guide the next step. You may notice temporary numbness or a heavy feeling in the leg that wears off.
Recovery
Most people resume normal activity the next day. If a steroid was included, any therapeutic benefit may build over several days. Mild soreness at the injection site is common and usually settles quickly.
QUESTIONS
Frequently asked questions
Is a genicular nerve block the same as radiofrequency ablation?
No. The block uses anesthetic to temporarily quiet the genicular nerves and is often a diagnostic test. Radiofrequency ablation uses heat to interrupt those same nerves for longer-lasting relief, and a successful block is typically required before ablation is considered.
How long does the relief last?
Relief from the anesthetic portion is short-lived, often lasting hours, which is expected for a diagnostic block. If a corticosteroid is added, some patients experience longer relief, though responses vary from person to person.
Will this cure my knee arthritis?
No. A genicular nerve block does not reverse arthritis or repair the joint. It is a pain-management tool that targets the nerves carrying pain signals, and it can be an option for patients who are not candidates for knee replacement or who wish to delay it.
LEARN MORE
Related care at Columbia Pain & Spine Institute
Genicular nerve blocks are part of our broader range of nerve block procedures. Explore all of our services, or learn about related treatments below.
Radiofrequency Ablation
Heat-based treatment for longer-lasting knee relief after a successful diagnostic block.
Femoral Nerve Block
Targeted block for anterior thigh and knee pain.
Peripheral Nerve Block
Image-guided block of a peripheral nerve for focal pain elsewhere in the body.