Genicular Nerve Blocks

The analgesic paradigm for chronic pain analgesia of the knee continues to be a moving target with extensive changes in the past two decades. Guidelines have ranged from intraarticular injections with steroids or hyaluronic acid to stem cells to ablation of various nerves targeted to best address chronic pain sources of the knee. Beginning in the early 2000s, anesthesiologists explored targeting smaller sensory nerves around the knee to relieve pain for perioperative pain, and the pain physician has followed suit. A focus on sensory nerve blocks has gained popularity, with providers exploring the potential of genicular nerve blocks and ablative techniques in lieu of painful knee surgeries or revisions for the management of knee pain. Advancements in ultrasound imaging and fluoroscopy have allowed for accurate visualization of structures and needle placement. In recent years, genicular nerve blocks have become an accepted form of pain relief treatment for conditions such as osteoarthritis, rheumatoid arthritis, failed knee surgery, and meniscal tears.