Genicular Nerve Blocks for Knee Osteoarthritis: Are They Worth It?
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By Dr. Jeffrey Peng, MD · Published March 4, 2026 · 5 min read
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If you have knee osteoarthritis and conventional treatments like over-the-counter pain medications or cortisone injections have not provided adequate relief, genicular nerve blocks may be a treatment worth considering. This ultrasound-guided procedure targets the specific nerves responsible for transmitting knee pain to the brain, offering meaningful short-term relief that can help you get moving again.
In this post, I will explain what genicular nerve blocks are, review what the clinical evidence says about their effectiveness compared to other treatments, and share how I recommend incorporating them into a comprehensive knee osteoarthritis management plan.
What Are Genicular Nerve Blocks?
Genicular nerve blocks are an advanced pain management procedure for knee osteoarthritis. The treatment works by injecting a local anesthetic near the genicular nerves — the nerves that carry pain signals from the knee joint to the brain. Three genicular nerves are typically targeted during the procedure: the superolateral genicular nerve, the superomedial genicular nerve, and the inferomedial genicular nerve.
The procedure is performed in an office setting under ultrasound guidance, making it extremely safe with a very low risk of side effects or complications. One of the most interesting aspects of genicular nerve blocks is that although the local anesthetic wears off within a few hours, many patients experience sustained pain relief lasting several months.
Do Genicular Nerve Blocks Work Better Than Placebo?
A randomized controlled trial by Shanahan et al. compared genicular nerve blocks to placebo injections in patients with knee osteoarthritis. The results showed that participants who received the nerve block experienced significantly greater improvements in both pain and functional scores compared to the placebo group. The most pronounced benefits were observed in the first one to two months, with a gradual return toward baseline pain levels by the three-month mark (Shanahan et al., 2023).
This study confirms that genicular nerve blocks provide real, measurable pain relief beyond placebo — but the effect is time-limited, which is an important factor when planning treatment.
How Do Genicular Nerve Blocks Compare to Physical Therapy?
A prospective randomized study by Güler et al. randomized over 100 patients to receive either a genicular nerve block or 10 sessions of physical therapy. At three months, both groups showed similar improvements in pain scores.
However, the genicular nerve block group demonstrated a more significant increase in walking distance by the 12-week assessment. These findings suggest that while both treatments effectively reduce pain and improve function, genicular nerve blocks may offer superior long-term benefits in terms of physical capacity for individuals with knee osteoarthritis (Güler et al., 2022).
Can Combining Nerve Blocks With Cortisone Improve Results?
A randomized study by Yilmaz et al. compared a single cortisone injection alone versus a cortisone injection combined with a genicular nerve block. While patients in both groups experienced notable improvements, those who received both the cortisone injection and the genicular nerve block showed more substantial improvements across multiple outcome measures — including pain levels, functional status, and overall quality of life (Yilmaz et al., 2021).
This finding highlights the potential added value of incorporating genicular nerve blocks alongside other injection therapies for a more comprehensive approach to pain management.
Are Genicular Nerve Blocks Safe?
Safety is always a critical consideration for any medical intervention. A systematic review by Tan et al. evaluated the available evidence on ultrasound-guided genicular nerve blocks and found that the procedure is both effective in reducing pain and enhancing functional abilities. Notably, none of the nine studies included in the review reported any adverse effects associated with the procedure (Tan et al., 2022).
In my practice, the majority of genicular nerve block procedures use local anesthetics like lidocaine, which are well-established for their safety and minimal side effects. This strong safety profile makes me confident in recommending this procedure to my patients.
How I Recommend Using Genicular Nerve Blocks in Practice
Based on the evidence and my clinical experience, genicular nerve blocks are most valuable as an adjunctive treatment rather than a standalone solution. The primary benefit is concentrated in the first one to two months, during which patients experience significant improvements in pain and function. After about two to three months, most patients notice a gradual return toward their baseline.
This is precisely why I recommend combining genicular nerve blocks with exercise therapy. A key challenge in managing knee osteoarthritis is that many patients are caught in a frustrating cycle: they know they need to exercise, but the pain is too severe to get started. Medications like ibuprofen, naproxen, or acetaminophen — and even cortisone injections — sometimes fall short.
Genicular nerve blocks can break that cycle by providing substantial short-term pain relief, creating a window of opportunity to engage in aerobic exercise and muscle-strengthening programs. Exercise therapy is not only one of the most effective long-term pain management strategies for osteoarthritis, but it also plays a crucial role in slowing disease progression — whether you have mild arthritis or severe bone-on-bone changes.
I specifically recommend genicular nerve blocks for patients experiencing severe pain where conventional treatments have been ineffective. They are particularly valuable for patients who are not candidates for knee surgery, those who prefer to delay surgery, or those who have not achieved sufficient relief from other pain management methods. If you are considering this treatment, I encourage you to schedule a consultation to discuss whether genicular nerve blocks are right for your situation.
What About Insurance Coverage?
Genicular nerve blocks may be covered by Medicare and some private insurance plans under specific conditions. However, many PPO plans require prior authorization, which can add complexity to the process. I recommend contacting your specific insurance provider to confirm whether genicular nerve blocks are a covered benefit under your plan before scheduling the procedure.
References
1. Shanahan EM, Robinson L, Lyne S, et al. Genicular Nerve Block for Pain Management in Patients With Knee Osteoarthritis: A Randomized Placebo-Controlled Trial. Arthritis Rheumatol. 2023;75(2):201-209. doi:10.1002/art.42384
2. Güler T, Yurdakul FG, Önder ME, et al. Ultrasound-guided genicular nerve block versus physical therapy for chronic knee osteoarthritis: a prospective randomised study. Rheumatol Int. 2022;42(4):591-600. doi:10.1007/s00296-022-05101-8
3. Yilmaz V, Umay E, Gundogdu I, Aras B. The comparison of efficacy of single intraarticular steroid injection versus the combination of genicular nerve block and intraarticular steroid injection in patients with knee osteoarthritis: a randomised study. Musculoskelet Surg. 2021;105(1):89-96. doi:10.1007/s12306-019-00633-y
4. Tan YL, Neo EJR, Wee TC. Ultrasound-guided Genicular Nerve Blockade With Pharmacological Agents for Chronic Knee Osteoarthritis: A Systematic Review. Pain Physician. 2022;25(4):E489-E502. PMID: 35793174
Medical Disclaimer: This content is for educational purposes only and does not substitute for the medical advice of a physician. Always consult your healthcare provider before beginning any new treatment program. The information presented reflects the opinion of Dr. Jeffrey Peng and does not represent the views of his employers or affiliated hospital systems.
