Nerve block for knee pain relief

A Flinders team has led a clinical trial to show how patients can receive temporary pain relief by blocking nerves around knee osteoarthritis sites.

The results, just published in high-ranking Wiley journal Arthritis & Rheumatology, trialled the method in a randomised trial of 59 patients using an ultrasound-guided genicular nerve block or a placebo injection. Participants recorded their pain on a scale of 0 to 10 at baseline then after two, four, eight and 12 weeks.

The study found patients with knee osteoarthritis may experience short-term pain relief from genicular nerve blocks or locally injected anaesthetics that block nerves around the knee joint, says lead researcher Professor Michael Shanahan, from Flinders University and the Southern Adelaide Local Health Network Rheumatology Unit at Flinders Medical Centre.

Professor Michael Shanahan, Flinders Medical Centre clinician.

While the benefits of the relief diminished over time, most patients who received the blocks felt they had improved or greatly improved from baseline during the follow-up period.

The scores recorded for nerve block versus placebo at baseline, weeks 2, 4, 8, and 12 were: 6.2 versus 5.3, 2.7 versus 4.7, 3.2 versus 5.1, 3.9 versus 4.9, and 4.6 versus 5.1, respectively.

“This study demonstrates that genicular nerve block is an effective short-term therapy for pain management in people with knee osteoarthritis,” says Professor Shanahan.

“We think it may be a useful treatment option for this group of people, in particular those waiting for, or wishing to defer surgery.”

Osteoarthritis of the knee is a major public health issue where treatment is often problematic, he says.

“Genicular nerve block (GNB) is a novel therapeutic intervention that may help to manage the pain from knee OA.”

Professor Shanahan presented the study findings were at this year’s Flinders Research Week and the recent annual scientific meeting of the American College of Rheumatology in the US. More information at the ACR Converence 2022 podcast.

The article, Genicular Nerve Block for Pain Management in Patients With Knee Osteoarthritis: A Randomized Placebo-Controlled Trial (2022), by EM Shanahan, L Robinson, S Lyne, R Woodman, F Cai, K Dissanayake, K Paddick, G Cheung and F Voyvodic has been published in the international journal Arthritis and Rheumatology (American College of Rheumatology) DOI 10.1002/art.42384.

Acknowledgement: The research was funded by Flinders Foundation.

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