General aches, soreness, and fatigue affect everyone now and then, but above all else, American adults’ number one physical complaint is knee pain. Whether it stems from an acute injury or a progressive degenerative disease, the knee tends to take the brunt of gradual wear-and-tear, as well as blunt force trauma. And when your knee is out of commission, so are you.
From simple conservative treatments like RICE (rest, ice, compression, and elevation) to total knee replacement surgery, with several other modalities in between, chances are good that your knee will recover from whatever ails it over time.
But what do you do when it doesn’t recover, and your knee pain persists for months on end? This is often the point when people seek out Dr. Jay Shah, our double board-certified physician here at SamWell Institute for Pain Management in Colonia and Livingston, New Jersey. Here’s how Dr. Shah gets to the root of your knee pain that others couldn’t find, and how he stops it.
Knee pain is complicated. The joint comprises a complex system of ligaments, muscles, tendons, bone, cartilage, and nerves that rely on healthy tissue to perform reliably. When those tissues become damaged, diseased, or deteriorated, it drastically affects your mobility and causes a great deal of pain.
Depending on the cause, as well as your weight, age, and general health, your knee condition may resolve over time with proper treatment, including physical therapy, medications, corticosteroid injections, and surgery. But some conditions don’t respond to these typically effective treatments.
Known as the wear-and-tear disease, osteoarthritis is the most common form of arthritis, and it plagues more than 32.5 million Americans. When it happens in your knee, the protective cartilage that once provided a slippery surface so your joint could move smoothly, thins out and wears away. Pain, stiffness, and inflammation are your constant companions, and there’s no cure. You can try pain medications, anti-inflammatories, even steroid or viscosupplementation injections, and you may get a little relief, but nothing brings back the lost cartilage, so you remain in pain.
Surgery is a great option for many types of knee injuries for select candidates, but sometimes pain can persist even after arthroscopic repair or total knee replacement. Post-surgical knee pain can be frustrating, and can cause severe pain and decrease in function and quality of life.
Dr. Shah has treated many patients who have had persistant chronic knee pain even after knee arthroscopic surgery or total knee replacement. It is even possible to treat the nerves that were affected as a result of a knee surgery. In these cases, medications, targeted image guided injections, and even a second surgery may be in order, but there’s no guarantee they’ll help.
Fortunately, Dr. Shah specializes in stopping pain even when other treatments haven’t worked. For chronic knee pain, he evaluates your condition thoroughly and determines the root cause of your ongoing pain. Then, he recommends the best course of treatment, which may include dorsal root ganglion or peripheral nerve stimulation, or he may suggest genicular nerve ablation.
Your genicular nerves provide sensitivity — and pain — to your knee, and when one of them won’t stop transmitting, Dr. Shah can effectively turn it off. Genicular nerve ablation uses radiofrequency energy to deactivate the nerves that send the constant pain signals to your knee and surrounding structures. The treatment uses no medication and is performed completely outside your knee under precise image guidance.
However, before he takes this step, Dr. Shah tests your nerves to identify which one is the culprit and to make sure that genicular nerve ablation will work for you. The trial test is a genicular nerve block, an injection of numbing anesthesia. He uses fluoroscopy or live ultrasound to guide the slender needle to the precise nerve he’s targeting.
If the genicular nerve block stops or decreases your pain by at least 50%, Dr. Shah considers it a success and performs the radiofrequency genicular nerve ablation with confidence that you’ll experience dramatic pain relief, for up to a year in some people.
This gives you pain-free time to focus on healing the injury and participating in essential physical therapy and knee specific rehabilitation to strengthen your knee and its muscles. If the pain returns, Dr. Shah can repeat the procedure after 6-12 months.
To learn more about genicular nerve ablation, and to find out if it can help your chronic knee pain, call us at either of our SamWell Institute for Pain Management locations, or book a consultation with Dr. Shah online.
