Knee Pain
Knee pain is commonly due to osteoarthritis which is a deterioration in the cartilage within the knee joint itself. This occurs due to ageing with repeat load-bearing and trauma throughout life. As the cartilage wears down, the protective space between the bones decrease which results on bone rubbing on bone. This can produce painful bone spurs. Other causes of knee pain can include soft tissue injuries such as ligament / tendon injuries and bursitis.
Treatment for knee pain can include a combination of analgesia, physiotherapy, weight loss and procedural interventions.
A genicular nerve block and rhizotomy may result in a significant reduction in knee pain. This can be performed to delay the need for a knee replacement, or performed after a knee replacement if there continues to be pain. Genicular nerves arise from the branches of the tibial and common peroneal nerves. The tibial nerve divides into the superior and inferior medial genicular nerves. The common peroneal nerve divides to form the superior lateral genicular nerve and inferior lateral genicular nerve. The lateral genicular nerve is often avoided when performing radiofrequency ablation due to its promity to the common peronal nerve as there is a risk for foot drop if this nerve is targeted. The branch of the vastus intermedius may be blocked for subpatellar pain.
Some patients may benefit from viscosupplment injection (Synvisc) that supplements the fluid in your knee to help lubricate the knee joint. This may be useful for those suffering from knee osteoarthritis that have failed non-interventional therapies. Synvisc contains hyaluronan which is a natural gel-like mixture that is found in the body and is present in very high amounts within joints. Hyaluronan acts as a shock absorber and lubricant in the joint. It can be easily injected under ultrasound guidance and repeat injections can be performed.
Helpful Resources:
- Arthritis Australia: Knee arthritis information
- Musculoskeletal Australia: Managing your pain
- The Pain Toolkit
DisclaimerThe above information is for general education only and is not intended as a substitute for your own independant health advice. At Western Pain clinic we comprehensively assess each patients pain condition and provide advice using the latest evidence-based treatments. If you would like to find out more information about knee pain, please discuss this with our doctor during your consultation.