At Blackberry Clinic our Pain Medicine and Musculoskeletal Medicine specialist doctors have a variety of treatments and injections which may help very acute or chronic painful spinal or joint conditions. Here one of our team of Pain Clinic Doctors, Dr Shyam Balasubramanian explains what knee genicular nerve radiofrequency treatment is, what conditions it is a treatment for and what to expect if you are booked in for this procedure.
Genicular nerves are a cluster of nerves around the knee joint that transmit information from the joint to the brain. Pulsed radiofrequency of genicular nerves is a safe and minimally invasive procedure that alleviates pain and disability in patients with degenerative disease or with previous knee surgeries.
Pulsed radiofrequency treatment is a procedure that aims to change the way the pain signal is transmitted through the nerves. The pain signal is modulated by applying an electrical field close to the nerve with a special needle connected to the radiofrequency device. By selectively applying the radiofrequency field to the genicular nerves surrounding the knee, one can effectively relieve joint pain.
If the person gets temporary pain relief with the numbing medicine and steroid injections, it is possible that following genicular nerve pulsed radiofrequency treatment they may experience longer lasting pain relief. Pulsed radiofrequency treatment offers the advantage of pain control without the tissue destruction.
When is this treatment used?
Are there any risks?
No pain injection procedure can be totally risk free. The risks include injection soreness, bruising, allergic reaction to the medicines used, infection and failure to relieve pain. Rare complications include persistent numbness and weakness. All measures will be taken to minimise risks and increase safety. This includes using x-ray or ultrasound to identify the correct location, taking infection precautions and the safety mechanisms inbuilt within the radiofrequency machine.
What happens during the procedure?
Your doctor will discuss the procedure with you and ask you to sign a consent form. As the procedure involves the use of x-ray, female patients in the childbearing age group will be asked about pregnancy. Please bring a list of your current medications with you. The treatment is done in a clean procedure room with x-ray / ultrasound. This allows the doctor to identify the location of the specific nerves around the knee. Depending on where the pain is felt in the knee joint, up to four nerves will be treated (3 above the knee, and 1 below the knee). Usually, one knee is treated at a time.
A sticky plate will be placed on your body which will be connected to the radiofrequency machine, in order to make an electric circuit. Once you are lying on the couch in the correct position, the doctor will clean your knee with an antiseptic solution. Numbing medicine will be injected before the special electrode needles are inserted. The doctor will make sure that the tip of the needle is in the right place and then stun the nerves.
In general, this is not very painful and is tolerated very well. After the treatment, more numbing medicine will be injected to minimise the soreness following the treatment. In the procedure room, the total treatment time takes about 30 to 45 minutes. A small dressing will be placed over the injection sites which can be removed the next day.
What happens after the treatment?
Following the procedure, the staff will observe you for some time and then you will be discharged. Please be careful when you first get off the trolley – ensure you are steady on your feet. We advise you to avoid driving on the day of treatment.
Take your regular medication and pain killers as normal. There may be an initial increase in discomfort before you experience pain relief. Successful treatment can result in pain relief lasting several months.
Musculoskeletal and Pain Medicine Consultant
