What it is for
Local anaesthetic is placed near selected genicular nerve targets using X-ray or ultrasound guidance. You may be asked to compare familiar painful activities before and after the block and record the degree and duration of change.
Selected chronic knee pain pathways
Chronic Knee Pain, Genicular Nerve Blocks and Radiofrequency
A staged, image-guided pathway for selected knee pain—starting with assessment and usually a diagnostic nerve block before radiofrequency is considered.
Consultant-led assessment by Dr Shamim Haider
Image-guided diagnostic and treatment stages
No guarantee of benefit or fixed duration
Private care in Colchester and Ipswich
Pain treatment, not structural repair
Genicular procedures aim to reduce pain signalling. They do not reverse arthritis or repair a knee replacement.
Start with the diagnosis
Not every painful knee is a genicular procedure problem
Knee pain can arise from osteoarthritis, inflammation, injury, referred pain, previous surgery or several factors together. The consultation considers whether the symptoms fit a pathway that targets sensory nerves around the knee and whether other treatment remains more appropriate.
What to expect from a private pain consultationWhere the pain is felt and what movements or activities provoke it
Whether osteoarthritis, previous surgery or another knee problem may be relevant
What rehabilitation, medicines, injections or surgical opinions have already been tried
Whether the aim is better walking, sleep, exercise, rehabilitation or day-to-day function
Persistent pain after knee replacement needs a separate check.
A genicular procedure does not identify or correct infection, loosening, instability or another implant-related problem. Orthopaedic review may be needed before a pain procedure is considered.
A staged pathway
From assessment to a possible radiofrequency procedure
- 1
Clinical assessment
The first step is to decide whether the pain pattern and previous treatment make a genicular pathway reasonable, and whether another knee or medical assessment is needed first.
- 2
Diagnostic genicular nerve block
Small amounts of local anaesthetic are placed near selected sensory nerve targets around the knee using image guidance. The response is recorded over the expected test period.
- 3
Review the result
A meaningful temporary improvement may support considering radiofrequency. A weak, unclear or very short-lived response may point away from proceeding.
- 4
Radiofrequency when appropriate
Radiofrequency energy is applied near selected genicular nerve targets with the aim of reducing pain signalling for longer than the diagnostic block.
The test stage
What a diagnostic genicular nerve block can—and cannot—tell us
What it does not prove
A positive response supports—but does not guarantee—the chance of benefit from radiofrequency. Placebo effects, local spread and day-to-day variation can influence the result, so the response is interpreted alongside the wider assessment.
The longer-acting stage
Genicular radiofrequency denervation
Radiofrequency uses a specialised needle and controlled energy at selected sensory nerve targets around the knee. The aim is to reduce pain transmission for longer than the local-anaesthetic block, creating an opportunity for better activity or rehabilitation.
NICE permits radiofrequency denervation for osteoarthritic knee pain with standard clinical governance, consent and audit arrangements, and reports good evidence of short-term pain relief without major safety concerns. Results still vary between people.
Read the general radiofrequency and denervation guideReasonable expectations
The procedure may reduce pain but does not restore cartilage or remove every source of knee pain. Benefit can be partial, temporary or absent, and nerves can recover over time.
Safety and consent
Benefits, limitations and risks are discussed together
The precise risk profile depends on your health, medicines, anatomy, image-guidance route and the technique proposed. The consent discussion is individual rather than a generic checklist.
Temporary soreness, bruising or an increase in pain around the needle sites
Temporary numbness, altered sensation or local tenderness around the knee
Bleeding, infection, allergic reaction or medication-related complications
Injury to a nearby nerve, blood vessel or other structure, which is uncommon but can be serious
No useful pain relief, or benefit that is smaller or shorter than hoped
Contact the treating hospital urgently after a procedure if you develop increasing redness or swelling, fever, severe worsening pain, new significant weakness, or another symptom that concerns you. For an emergency, use urgent NHS services.
FAQ
Questions about genicular nerve procedures
Genicular nerves are small sensory nerve branches that carry some pain signals from the knee. A genicular procedure targets selected nerve locations around the joint; it does not repair cartilage, ligaments or a knee replacement.
No. A genicular nerve block places local anaesthetic near selected sensory nerves outside the joint. An intra-articular injection places medication inside the knee joint. They have different purposes and are selected differently.
The block is a short test of whether temporarily reducing signalling from the selected nerves changes the pain in a meaningful way. It can help with selection for radiofrequency, but it is not a perfect prediction and does not guarantee a longer-term result.
Benefit varies. NICE found good evidence of short-term pain relief in osteoarthritic knee pain, and some patient information describes benefit lasting longer. Nerves can recover and pain may return. No fixed duration can be promised for an individual patient.
Selected patients with persistent pain after knee replacement may be considered only after a separate assessment. Genicular treatment does not diagnose or correct infection, loosening, instability or another problem with the implant, so orthopaedic review may be needed first.
The targets are sensory branches rather than the main nerves controlling the leg. Temporary altered sensation or numbness can occur. Significant weakness or persistent neurological symptoms are uncommon and should be assessed promptly.
No. It is one possible pain-management option. It may help some people participate in rehabilitation or manage symptoms when surgery is not currently suitable, but it does not reverse osteoarthritis or replace an orthopaedic decision when surgery is indicated.
Tell the team about blood-thinning medicines, allergies, infection, pregnancy or possible pregnancy, recent changes in health and any planned travel. Do not stop prescribed medicines unless you have been given individual instructions.
Reliable UK information
Guidance and patient information used for this page
NICE
Radiofrequency denervation for osteoarthritic knee pain
Faculty of Pain Medicine
Genicular nerve radiofrequency lesioning patient leaflet
NHS
Osteoarthritis treatment and support
RNOH NHS
Genicular diagnostic block and denervation guide
Booking
Arrange a private knee-pain assessment
The consultation establishes whether a genicular pathway is clinically appropriate. Current procedure availability and fees are confirmed by the hospital.
Oaks Hospital, Colchester
120 Mile End Road, Colchester, CO4 5XR
Nuffield Health Ipswich
Foxhall Road, Ipswich, IP4 5SW