The Washington State Department of Labor & Industries made a coverage decision on therapeutic genicular nerve blocks recently. Genicular nerve block for treating chronic knee pain is not a covered benefit, effective October 1, 2018.
The knee joint is innervated by the articular branches of several nerves including the femoral, common peroneal, saphenous, tibial and obturator nerves. These articular branches around the knee joint are known as genicular nerves.
Per the Department of Labor and Industries, genicular nerve block for treating chronic knee pain is controversial. The effectiveness of the procedure on relieving chronic knee pain is not established. The safety of repetitive anesthetic/steroid injections to the genicular nerves is unproven.
The white paper produced to outline the basis for this decision includes reference to the practice guideline published by The American Society of Anesthesiologists, “Practice Guidelines for Chronic Pain Management” in 2010 . It pulls the quote from the document “peripheral somatic nerve blocks should not be used for long-term treatment of chronic pain”. The paper’s conclusion statement is: “The evidence regarding genicular nerve block is scant. Though some evidence showed that GNB might provide short-term pain relief, the effectiveness of this procedure on chronic knee pain has not been established. The safety and effectiveness of repetitive anesthetic/steroid injections are unproven.”
Genicular nerve block (GNB) may be performed for diagnosis or perioperative care. GNB for treating chronic knee pain is not covered.