Preventing Knee Surgery with Nerve-Pain Treatments

Winter is rough for people with osteoarthritis. Slippery sidewalks and winter sports increase the risk of falls, and joints seem to throb more in cold, damp weather.

Over-the-counter medication might bring relief, but side effects are linked to the prolonged use of drugs such as ibuprofen.

For severe pain, your primary care doctor may prescribe prescription drugs and physical therapy. If the condition becomes advanced, surgery might seem like the only solution. But that’s not necessarily the case.

Interventional pain management is a safe way to manage chronic discomfort. Treatment includes steroid and cortisone joint injections and platelet-rich plasma therapy that accelerates the healing of injured tendons, ligaments, muscles and joints.

ChristianaCare also offers genicular nerve block and genicular radiofrequency ablation, two revolutionary outpatient procedures that can prevent or delay the need for surgery.

What is genicular nerve block?

The treatment involves an injection of anesthesia, which temporarily blocks pain signals that radiate from the nerves around the knee. (The area is numbed first.) Once blocked, the nerves no longer send pain information to the brain.

What is genicular radiofrequency ablation?

Using heat, the surgeon selectively damages the nerves that transmit pain, so they’re no longer sending signals to the brain. By using an x-ray technique called fluoroscopy, the doctor can be precise with the needle. A successful procedure may eliminate the need for pain medication.

How do I know if these procedures are for me?

 Talk to your doctor if you want to avoid surgery or if you have any of the following:

• Chronic knee pain secondary to osteoarthritis.
• Chronic conditions that keep you from having invasive surgeries.
• A failed knee replacement.

Which procedure comes first?

You will receive a genicular nerve block first. Another block will ensure that the doctor is targeting the right area. Patients then keep track of any discomfort or pain-free activities in a pain diary. If you have a 50% reduction in pain, the specialist may recommend genicular radiofrequency ablation.

Are these procedures a substitute for a knee replacement?

Not if a knee replacement is indicated. The treatments do not treat the joint, only the pain. But if the joint is otherwise in acceptable shape, removing the pain can delay or avoid the need for surgery.

Are there possible complications?

 Needle-positioning technology is so precise that complications are rare. You may have an allergic reaction to the anesthetic, but it’s uncommon. The infection rate is low.

Will I need another treatment?

Many patients need another treatment in 12 months.

Do these treatments only address the knee?

No, interventional pain management specialists are also using these procedures on the shoulder and back.

To contact Dr. Chiu and ChristianaCare’s Comprehensive Pain Center, call 302-623-3450.