Joint Denervation for Joint Pain

Joints can develop pain for a variety of reasons including trauma and arthritis. Typical treatments include non-operative measures such as anti-inflammatory medications, steroid injections, and physical therapy or operative measures such as joint replacement (arthroplasty) or joint fusion (arthrodesis). The procedure of joint denervation is based on the premise that the sensation of pain is transmitted by nerve fibers. Denervation is the process of interrupting nerve signals from a specific location. By denervating a joint, the sensation of pain arising from painful joints may be disrupted, which may permit delay or avoidance of more invasive surgical procedures such as arthroplasty, revision arthroplasty, or arthrodesis.

Evaluation is uniquely tailored to each patient and the involved joint. Treatable orthopedic injuries should be evaluated and addressed if present. This may require imaging with x-rays or MRI. For smaller joints in the hand and wrist, patients should have attempted non-operative interventions without achieving sufficient pain relief. For larger joints such as the knee, patients often have undergone arthroplasty (joint replacement) with only partial pain relief. Often, a nerve block is performed with an injection of local anesthetic near the painful joint. If this leads to significant relief of pain, then this typically indicates that this nerve is involved with the joint pain and should be targeted with joint denervation surgery. Of note, a local anesthetic injection provides only temporary relief and will not cure pain; it is intended only to assist with diagnosis and treatment planning.

Joint denervation surgery typically involves one or several small incisions (1-2” in length) near the affected joint. The involved nerve transmitting the pain signal is identified and cut. The surgery usually takes less than an hour. Nerves that provide sensation to the skin usually are not affected so that there should be little or no resulting numbness of the nearby skin, although this is a risk of this surgery. Commonly treated joints involve the thumb, fingers, wrist, elbow, knee, and ankle.

The small incisions heal quickly, and patients often are fully recovered within 2-4 weeks.

Be sure to see an experienced surgeon to treat this condition. Our fellowship-trained specialists at The Buncke Clinic in San Francisco treat patients using joint denervation for joint pain from across the Bay Area and Northern California. Contact us to schedule a consultation.