Knee pain is one of the most common musculoskeletal complaints affecting people of all ages. It may result from injuries, overuse, degeneration, nerve-related problems, or underlying medical conditions. Understanding what causes knee pain helps ensure accurate diagnosis, effective treatment, and long-term relief.
Dr. Shravan Tirunagari, a specialist in knee disorders and advanced pain management, explains that knee pain can come from not only structural damage but also chronic pain pathways and nerve dysfunction. A detailed clinical evaluation, supported by imaging and nerve-based diagnostic techniques, is essential for identifying the root cause.
Role of a Pain Consultant in Knee Pain
A Pain Consultant is a medical specialist focused on evaluating, diagnosing, and creating tailored treatment plans for all forms of chronic and complex pain. Their approach goes beyond symptom control; they aim to identify and treat the root cause of pain through a comprehensive, multi-disciplinary strategy.
A Pain Consultant Helps Manage:
1. Post-Surgery Pain (Persistent Surgical Pain)
Many patients experience long-lasting pain even after surgeries such as Total Knee Replacement (TKR). Pain consultants use targeted medications, injections, and nerve-modulating procedures to address nerve irritation, inflammation, or scar-related pain.
2. Nerve Pain (Neuropathic Pain)
Burning, tingling, electric-shock-like pain often results from irritated or injured nerves. Pain consultants use:
- specialized medications
- nerve blocks
- nerve stimulation techniques
to calm and reset abnormal nerve activity.
3. Sports Injury
For athletes wanting to avoid surgery, pain consultants offer:
- regenerative treatments (PRP)
- ultrasound-guided injections
- focused physiotherapy
to restore function and reduce inflammation.
4. Complex Regional Pain Syndrome (CRPS)
A debilitating chronic pain condition requiring:
- nerve-calming medications
- sympathetic nerve blocks
- advanced neuro-modulation techniques
A pain consultant is specially trained to diagnose and treat CRPS effectively.
Management plans typically combine:
- Medications
- Physical Therapy
- Pain Psychology (coping strategies, behavioral therapy)
- Minimally Invasive Procedures
What Causes Knee Pain?
Knee pain commonly arises from injuries, overuse, degeneration, or misalignment. Pain consultants evaluate whether the source is structural, inflammatory, or nerve-related.
Common Categories of Knee Pain:
| Category | Common Examples | Description |
| Knee Injuries | ACL/MCL tears, Meniscus tear, Fractures, Dislocation | Trauma or twisting injuries common in sports |
| Arthritis | Osteoarthritis, Rheumatoid Arthritis, Gout, Septic Arthritis | Long-term inflammation causing cartilage wear |
| Overuse/Stress | Patellar Tendinitis, IT Band Syndrome, Bursitis | Repetitive strain from running, kneeling, improper form |
| Mechanical Issues | Loose body, Misalignment from hip/foot issues | Structural problems affecting knee movement |
| Degeneration | Aging, Excess body weight | Natural wear or excess stress accelerating joint breakdown |
A Closer Look at Knee Nerves: Genicular Nerves
The Genicular Nerves are small sensory nerves responsible for carrying pain signals from the knee joint to the brain.
Key Features:
- They branch from major nerves in the thigh and leg.
- Commonly targeted branches:
- Superior medial genicular nerve
- Superior lateral genicular nerve
- Inferior medial genicular nerve
- Superior medial genicular nerve
- These nerves lie close to the bone surfaces around the femur and tibia.
When these nerves become overactive, irritated, or hypersensitive, often due to arthritis or post-surgical changes, they cause chronic knee pain even after structural healing.
Genicular Nerve Block: Diagnostic Pain Test
A Genicular Nerve Block is a precise injection to confirm whether genicular nerves are the main source of knee pain.
How It Works:
- A small amount of local anesthetic is injected near the genicular nerves.
- The procedure is done under X-ray (fluoroscopy) or ultrasound guidance.
- If the patient experiences significant pain relief shortly afterward, it confirms that the pain is originating from these nerves.
A successful nerve block often leads to long-term treatment using Radiofrequency Ablation (RFA).
Advanced Pain Treatments for Knee Pain
Pain consultants specialize in minimally invasive, targeted treatments when standard therapies do not provide sufficient relief.
1. Radiofrequency Ablation (RFA) of Genicular Nerves
What It Is:
A minimally invasive procedure that uses controlled heat (radiofrequency energy) to disable the genicular nerves from sending pain signals.
How It Works:
- Done only after a successful diagnostic nerve block.
- A thin probe delivers heat to the nerve.
- The nerve stops transmitting pain signals.
Duration of Relief:
Pain relief usually lasts 6–12 months or longer because nerves regenerate slowly.
The procedure is safe and can be repeated if needed.
2. Platelet-Rich Plasma (PRP) Therapy for Sports Injury
What It Is:
A regenerative treatment using the patient’s own blood.
How It Works:
- Blood is collected and spun in a centrifuge.
- Platelets (containing growth factors) are concentrated.
- The PRP is injected into injured tendons, ligaments, or joint spaces.
Goal:
To accelerate the body’s natural healing response in slow-healing tissues.
3. Stem Cell Research (Regenerative Medicine)
What It Is:
Advanced research exploring the use of Mesenchymal Stem Cells (MSCs) to repair damaged tissues.
How It Works (Research Focus):
- Stem cells from fat or bone marrow may help reduce inflammation.
- Potential to regenerate cartilage or nerve tissue.
Status:
Still considered investigational or experimental, but rapidly evolving with promising results.
4. Peripheral Nerve Stimulation (PNS)
What It Is:
An advanced therapy for chronic neuropathic (nerve-related) pain.
How It Works:
- A tiny wire is placed near the damaged peripheral nerve.
- It delivers mild electrical impulses.
- These impulses “scramble” or block the pain signals before they reach the brain.
Use:
Highly effective when the exact nerve source is known, especially in long-standing nerve injuries.
Diagnosis of Knee Pain
Accurate diagnosis involves:
- Clinical examination
- X-ray
- MRI
- CT scan
- Blood tests
Pain consultants may also use nerve blocks to determine if pain is originating from specific nerves.
Treatment Options
Non-Surgical Treatment
- Rest, ice, and activity modification
- Anti-inflammatory medications
- Physiotherapy
- Knee braces
- Injections (corticosteroids, hyaluronic acid)
Surgical Treatment
- Arthroscopy
- Ligament reconstruction
- Partial or total knee replacement
Why Choose Dr. Shravan Tirunagari
Dr. Tirunagari is highly skilled in diagnosing and treating structural, inflammatory, and nerve-related knee pain. His expertise in genicular nerve procedures, RFA, regenerative therapies (PRP), PNS, and chronic pain management allows him to create personalized, minimally invasive treatment plans.
He focuses on:
- Accurate diagnosis
- Restoring mobility
- Relieving pain
- Enhancing long-term quality of life
Conclusion
Knee pain can arise from injuries, arthritis, degeneration, or chronic nerve dysfunction. A pain consultant plays a crucial role in identifying the exact cause and offering advanced treatment options from nerve blocks and RFA to regenerative injections and nerve stimulation.
If you are experiencing persistent knee pain, consult Dr. Shravan Tirunagari for a comprehensive and specialized evaluation.