Knee pain. At the nerve level.
The knee joint is innervated by several small nerves — the genicular nerves — that carry pain signals from the joint to the central nervous system. In patients with knee osteoarthritis, persistent post-surgical pain, or other chronic knee pain conditions, blocking these nerves with local anesthetic can substantially reduce pain that has not responded to other measures.
Genicular blocks are one of the pain procedures most ideally suited to ultrasound guidance. The target nerves are relatively superficial and easily visualized with modern ultrasound, and the surrounding vascular structures are also visible — allowing precise nerve targeting while avoiding nearby vessels. Fluoroscopy provides no advantage for this procedure and adds unnecessary radiation.
At NCSS, genicular blocks are performed by Dr. Scott personally in our AAAHC-accredited operating rooms. Sedation is available but often unnecessary for this well-tolerated procedure.
Who benefits from genicular blocks.
Genicular nerve blocks are appropriate for a specific set of patients. The following profiles describe who tends to benefit most.
Knee osteoarthritis pain
Chronic pain from knee OA that has not responded to NSAIDs, intra-articular steroid, or hyaluronic acid injections — particularly in patients who are not yet surgical candidates or who wish to defer surgery.
Persistent post-total-knee-arthroplasty pain
A meaningful minority of patients continue to have knee pain after successful knee replacement. Genicular blocks can provide relief when other measures have failed.
Poor candidates for knee surgery
Patients with medical contraindications to knee replacement or those wanting to avoid surgery.
Diagnostic clarity needed
Genicular blocks can help distinguish knee-joint-derived pain from pain of other origins (hip, spine, muscular) that can present as knee pain.
Realistic expectations
Genicular blocks typically provide weeks-to-months of relief; they are not a permanent solution but can be repeated at intervals for ongoing management.
Every pain-management patient at NCSS is seen personally by Dr. Rand Scott for the consultation — not delegated to a mid-level provider.
Three stages, one procedure.
Genicular nerve blocks are same-day procedures performed in one of our operating rooms. The steps:
Three genicular targets
The superolateral, superomedial, and inferomedial genicular nerves are typically targeted — providing coverage of most knee-joint innervation.
Ultrasound-guided placement
Each nerve is visualized in real time alongside the associated vascular structures. This allows precise nerve targeting while avoiding intravascular injection.
Local anesthetic +/- steroid
Small volumes of local anesthetic (with or without steroid, depending on clinical context) are deposited around each target nerve.
Well tolerated
Patients typically feel only the initial needle stick; the injection itself is minimally uncomfortable. Sedation is available but often not needed.
Bilateral if needed
Patients with bilateral knee pain can be treated on both sides in the same session.
The procedure itself typically takes 15–20 minutes. Total facility time is usually 45–75 minutes.
Two sites. One recovery.
Discharged shortly after the procedure. Most patients drive themselves home if sedation was not used.
The local anesthetic component provides substantial pain relief within minutes to an hour — often the most dramatic pain reduction the patient has experienced in months or years.
As the local anesthetic wears off, some pain returns. Steroid effect (when steroid is included) engages over subsequent days.
Duration of relief varies significantly. Some patients report benefit lasting several months. Response tends to be better with each subsequent injection as inflammation is managed longitudinally.
Immediate return to normal activity. Some patients feel enabled to increase their activity level as knee pain improves.
When effective, repeat injections are typically scheduled based on the patient's individual response pattern.
Follow-up with Dr. Scott occurs at Newport Pain Management for ongoing pain management coordination.
The medical director. Personally.
All interventional pain procedures at NCSS are performed by Dr. Rand Scott himself.
H. Rand Scott, MD
BOARD-CERTIFIED ANESTHESIOLOGIST · PAIN MANAGEMENT SUBSPECIALTYFounder of Newport Pain Management (1996) and Medical Director of NCSS. Ultrasound-guided technique, no fluoroscopy radiation.
Meet the medical director →The right starting point is a conversation.
Every pain-management patient at NCSS is seen personally by Dr. Rand Scott for the consultation — not delegated to a mid-level provider.
Call (949) 644-8182Monday–Thursday, 8am–3pm · Friday by appointment only.
Also at NCSS.
Epidural Steroid Injections
For back or leg pain from spine pathology — sometimes the root cause of what presents as knee pain.
Learn more →Facet Joint Injections
For facet-mediated back pain — occasionally a contributor when back pain presents alongside knee pain.
Learn more →Newport Pain Management
Dr. Scott's comprehensive pain practice adjacent to NCSS — for the broader diagnostic and treatment relationship.
Visit newportpain.com →