Genicular Nerve Block and Radiofrequency Ablation (GNRFA)

Genicular Nerve Block and Radiofrequency Ablation (GNRFA) by Dr. Vivek Loomba


Are you tired of living with knee pain? Have you tried everything from painkillers to physical therapy, but nothing seems to work? Well, it’s time to explore new treatment options that could provide lasting relief. This innovative treatment approach has rapidly gained popularity in the medical community and is being hailed as a game-changer for managing chronic knee pain. In this article, we’ll delve deep into what GNRFA is and how it can help alleviate your knee discomfort so that you can get back to doing the things you love without any hindrance. 

What are Genicular Nerve Block and Radiofrequency Ablation?

Genicular nerve block (GNB) is a minimally-invasive procedure that can be used to treat knee pain. It is primarily used as a diagnostic treatment to determine the root cause of the pain. During the procedure, a needle is inserted into the area around the knee joint and an anesthetic is injected into the genicular nerves while using fluoroscopic or ultrasound guidance. This numbs the nerves by providing relief from pain but the relief is short-lived. The effect lasts for only 8 to 24 hours. If a patient experiences maximum (50%) relief from GNB treatment then the doctors will repeat the procedure for long-lasting pain relief.

Radiofrequency ablation (RFA) is a longer-term pain relief treatment that responds well to diagnostic nerve block.  It inserts microelectrode into the cannula to heat the tip of the needle. This needle is used to damage the genicular nerves, which prevents them from sending pain signals to the brain. One nerve is targeted at a time and the same process is repeated for each and every affected nerve.

Both GNB and RFA are effective treatments for knee pain and can provide long-term pain relief over time. The pain relief from the treatment can last after a repetitive procedure is performed. If you are struggling with knee pain, talk to your doctor about whether GNB or RFA may be right for you.

Who should get GNRFA treatments?

GNRFA is a type of physical therapy that can help manage various issues of knee pain from –

  • Degenerative joint disease (Osteoarthritis)
  • Failed knee replacement
  • Medically unstable patients for knee replacement
  • Patients who want to avoid knee replacement. 
  • Knee injury with inflammation
  • Pain relief before or after surgery

GNRFA can also help to break up scar tissue and adhesions that may be causing pain or limiting movement.

How is the procedure performed?

During the procedure, a patient lies on the procedure table. A sterile solution is used to cleanse the area. A local anesthetic medication is given to the affected area for numbing. A special machine called fluoroscopy or ultrasound is used to find the area. The needle is directed to the target location for insertion and contrast dye is injected to find the accurate location. The local anesthetic injection is inserted for numbing the area of the skin. Steroids may also be used for inflammation reduction. The entire procedure is monitored by the physician. After the needle is removed, a small bandage is placed on the skin. You will be kept under observation for 40 to 50 minutes and the patient can leave home on the same day after the successful procedure. Patients may also experience some soreness and swelling around the knee for a few days after the procedure, but this can be managed with ice and over-the-counter pain medication. 

Risks and Side Effects

There are a few risks and complications associated with Genicular Nerve Block and Radiofrequency Ablation (GNRFA) treatments. These include:

  • Infection – There is a small risk of infection at the site of the injection or where the needle was inserted.
  • Bleeding or bruising – There is also a small risk of bleeding or bruising at the injection site.
  • Allergic reaction – In rare cases, an allergic reaction may occur. This could cause itching, swelling, or difficulty breathing. If you experience any of these symptoms, seek medical attention immediately.
  • Bladder or Bowel Dysfunction – Infrequent bowel movements and constipation.
  • Numbness or weakness – Leg muscle numbness that lasts for more than 8 hours.

Recovery Time

Knee pain is a common issue in most adults that can be caused by a variety of factors, including arthritis, injuries, and overuse. GNRFA is a new treatment option that has been shown to be effective in reducing knee pain, improving functionality, and providing long-term pain relief. The recovery time after the GNRFA procedure is typically shorter than other knee surgery options, and patients can expect to return to their normal activities within a few weeks.


Overall, Genicular Nerve Block and Radiofrequency Ablation (GNRFA) is an effective and safe treatment option for managing knee pain that has proven to be successful for many patients. It helps to reduce inflammation, improve the range of motion, and strengthen the muscles around the joint area. If you are suffering from chronic or acute knee pain, it may be worth considering this alternative form of therapy as a way to relieve your discomfort. Under proper guidance and care from professionals who specialize in GNRFA, it can help you manage your knee pain for healthy living.