By Dr. Suzanne Manzi, MD
Quadruple Board-Certified in Physical Medicine & Rehabilitation, Pain Medicine, Electrodiagnostic Medicine, and Obesity Medicine

Understanding Genicular Nerve Block for Knee Pain Relief

What do you do when chronic knee pain limits your ability to stay active, work comfortably, or enjoy daily life—and conservative treatments haven’t provided lasting relief? A genicular nerve block may offer the answer. This targeted, minimally invasive procedure interrupts knee pain signals by addressing the sensory nerves around your joint, providing both diagnostic clarity and meaningful relief.

As a physician quadruple board-certified in Physical Medicine & Rehabilitation, Pain Medicine, Electrodiagnostic Medicine, and Obesity Medicine, I understand how frustrating it is when knee pain doesn’t respond to physical therapy, oral medications, or standard injections. I co-founded Performance Pain and Sports Medicine to provide advanced interventional pain solutions for patients who need more than conventional approaches offer. A recent systematic review and meta-analysis confirms that these blocks reduce pain compared to placebo and some intra-articular therapies—giving patients a proven pathway toward relief.

In this guide, I’ll walk you through how genicular nerve blocks work, what the latest research shows about their effectiveness, who benefits most, and what you can expect during and after treatment at our practice.

Important Safety Information

Genicular nerve blocks are generally well-tolerated with a favorable safety profile. If you take anticoagulant or antiplatelet medications, discuss timing and management with your physician before the procedure—the American Society of Interventional Pain Physicians (ASIPP) provides evidence-based guidance for safe peri-procedural management of these medications. Temporary soreness at the injection site, mild bruising, or transient numbness may occur. The procedure is not recommended for patients with active infection near the injection site, uncontrolled bleeding disorders, or allergy to local anesthetics. Pregnant patients and those with certain neurological conditions should consult their physician to determine if genicular nerve block is appropriate.

How Genicular Nerve Blocks Work to Relieve Knee Pain

Your knee joint is innervated by multiple small sensory branches called genicular nerves—typically the superior lateral, superior medial, and inferior medial genicular nerves. These nerves transmit pain signals from the joint capsule, synovium, and surrounding structures up to your brain. When arthritis or surgical trauma irritates these tissues, these nerves keep sending pain signals even when the underlying condition is stable.

A genicular nerve block delivers local anesthetic directly to these nerve branches under ultrasound or fluoroscopic guidance, temporarily interrupting pain transmission without affecting motor function or knee stability. As the Cleveland Clinic explains in their patient education resource, the procedure serves two purposes: it’s diagnostic (confirming the nerves are the pain source) and therapeutic (providing weeks to months of relief).

Interestingly, a randomized controlled trial published in Pain Physician (2018) found that adding corticosteroid to local anesthetic did not provide additional pain relief or functional benefit over local anesthetic alone. This finding has practical implications—it suggests that the nerve block itself, rather than the anti-inflammatory effect of steroids, drives the pain relief. In my practice, this evidence informs how I tailor the injectate to each patient’s needs.

What the Research Shows: Effectiveness for Knee Osteoarthritis and Post-Surgical Pain

Pain Reduction in Knee Osteoarthritis

The evidence for genicular nerve blocks in knee osteoarthritis continues to grow. A systematic review and meta-analysis of randomized clinical trials (Clinical Journal of Pain, 2024) found significant pain reduction compared to placebo and some intra-articular therapies, with the most consistent relief in the short to mid-term. The authors note that while evidence supports these benefits, study heterogeneity and limited follow-up data warrant careful patient selection for optimal outcomes.

Functional outcomes show more variability—some studies demonstrate improved walking ability alongside pain reduction, while others show pain relief without significant functional change. A systematic review in Pain Physician (2022) reported pain and function improvement for up to six months, with a favorable safety profile and rare adverse events. In my experience, patients who combine the procedure with targeted physical therapy tend to see the strongest functional gains.

Post-Surgical and Persistent Knee Pain

These blocks also benefit patients with persistent pain after total knee arthroplasty or other knee surgeries. A systematic review and meta-analysis (2025) found reduced early postoperative pain in total knee arthroplasty patients, though longer-term functional outcomes remain an area of ongoing study. Diagnostic blocks are particularly valuable in this population because they identify whether pain is nerve-mediated rather than structural—guiding appropriate next steps rather than pursuing unnecessary revision surgery.

Predicting Response to Radiofrequency Ablation

One of the most important roles of a genicular nerve block is as a diagnostic tool. A positive response—typically defined as 50% or greater pain relief—is the strongest predictor of success with subsequent genicular nerve radiofrequency ablation, which can offer six to twelve months or more of sustained relief. A randomized placebo-controlled trial (2022) confirmed this diagnostic utility, showing significant pain relief versus placebo through eight weeks, with effects diminishing over time. This two-step approach—diagnostic block followed by ablation for responders—allows precise patient selection and maximizes the likelihood of lasting benefit.

Genicular Nerve Block as Part of a Comprehensive Pain Management Strategy

In my practice, a genicular nerve block is rarely a standalone treatment—it’s one component of a multimodal approach tailored to each patient’s needs. Your treatment plan may also include physical therapy to strengthen the muscles supporting your knee, activity modification, and—when appropriate—regenerative therapies such as platelet-rich plasma to address underlying joint degeneration.

The procedure fits into the treatment continuum after conservative measures have provided insufficient relief, but before surgical intervention becomes necessary. The Pain Physician (2022) systematic review noted a favorable safety profile with rare adverse events, making this an attractive option for patients who want to avoid or delay surgery. The minimally invasive nature means you’re not trading weeks of recovery for pain relief—you’re gaining relief while staying active.

Genicular Nerve Block for Active Adults in the Houston Area

Chronic knee pain shouldn’t sideline you from a career that requires standing or walking, weekend runs along the bayou, or family activities that keep you moving. Whether knee pain has kept you from enjoying outings at the Kemah Boardwalk or limited your ability to stay active, this procedure offers a practical solution with minimal downtime—most patients return to work the next day.

At Performance Pain and Sports Medicine, our physician-led, boutique model ensures individualized assessment and advanced interventional techniques. We serve Houston, League City, Baytown, Pearland, Sugar Land, and surrounding communities.

When Should You Consider a Genicular Nerve Block?

You might be a good candidate if you have chronic knee pain lasting three or more months that limits daily activities, work, or exercise despite conservative treatment. Patients with knee osteoarthritis confirmed on imaging whose pain doesn’t respond adequately to oral medications or physical therapy often benefit from this approach. It’s also worth considering if you have persistent pain after knee surgery when structural causes have been ruled out, or if you want to avoid or delay knee surgery while maintaining an active lifestyle.

If you’re avoiding activities you love, struggling through your workday, or relying heavily on pain medication, it’s worth having a conversation. Many patients wish they’d explored this option sooner—and a diagnostic block helps answer the question before committing to further treatment.

What to Expect During Your Visit at Performance Pain and Sports Medicine

Your visit begins with a thorough evaluation: I review your medical history, imaging studies, and prior treatments, then perform a focused physical exam to confirm the pain pattern and rule out other causes. If the procedure is appropriate, it can often be performed the same day or scheduled for a follow-up visit.

The injection itself takes about 15 to 20 minutes under ultrasound guidance. You lie comfortably on an exam table while the skin is cleaned and numbed. The block is then delivered to the target nerves around the knee—most patients report only mild pressure during the injection.

Afterward, you’ll rest briefly and receive post-procedure instructions. Over the following days, I’ll ask you to track your pain levels to assess your response. This information guides next steps—whether that’s a series of blocks for ongoing relief, progression to radiofrequency ablation for longer-lasting results, or integration with other therapies.

Comparing Treatment Approaches for Chronic Knee Pain

Hear From Our Community

Hearing from others who have faced similar challenges can help you understand what’s possible with comprehensive pain management. One patient recently shared their experience publicly.

Excerpt from a publicly shared patient review. Individual experiences vary.

This experience reflects what I hear from many patients—when pain sources are accurately identified through diagnostic testing and combined with a comprehensive treatment plan, meaningful improvement is possible.

Take the Next Step Toward Knee Pain Relief

Genicular nerve blocks offer a proven, minimally invasive option for adults living with chronic knee pain from osteoarthritis or post-surgical conditions. The procedure provides meaningful pain relief, helps identify candidates for longer-term radiofrequency ablation, and allows you to maintain an active lifestyle without surgery. From returning to the trails at Memorial Park to resuming your work responsibilities without limitation, the right treatment plan helps you reclaim the activities that matter most.

Results vary by individual—but our physician-led approach ensures you receive a thorough evaluation and the most appropriate interventional care across the Greater Houston area. If knee pain is limiting your work, activities, or quality of life, I encourage you to explore whether this procedure is right for you.

Frequently Asked Questions