Knee Pain After 60 Is Not Something You Have to Accept

September is Healthy Aging Month, and it arrives with a message worth repeating in every Prosper waiting room: getting older is not the same as accepting pain.

Knee pain is where that distinction gets tested most often. Osteoarthritis of the knee is genuinely common after 50 — but “common” is not the same as “untreatable,” and the gap between those two words is where a lot of people quietly lose years of mobility. They stop walking the neighborhood loop. They avoid the stairs at the grandkids’ house. They decline the trip.

The good news is that the space between over-the-counter medication and knee replacement surgery has gotten considerably wider. One of the most useful options in that space is the genicular nerve block, and most patients have never heard of it.

Why Knees Wear Differently Than People Expect

Knee osteoarthritis is often explained as “bone on bone,” which makes it sound purely structural. In reality, the pain experience is more complicated — and that is good news, because it means structure is not destiny.

Imaging and symptoms correlate imperfectly. Plenty of people have significant arthritic changes on X-ray and modest pain; plenty of others have mild changes and substantial pain. Inflammation, joint mechanics, muscle support around the joint, and how sensitized the surrounding nerves have become all contribute. Two people with identical films can have very different days.

The practical implication: the amount of cartilage you have lost does not automatically dictate how much pain you must live with, and it does not automatically mean surgery is the only remaining option.

What Genicular Nerves Are

The knee joint is supplied by a network of small sensory nerves called the genicular nerves. They carry pain signals from the joint to the spinal cord and brain. Critically, they are sensory only in the areas targeted — they do not control the muscles that let you walk, climb stairs, or stand up.

That anatomical fact is what makes them such an attractive target. If pain signals from an arthritic knee travel a known route, that route can be interrupted without touching the joint itself and without affecting your strength.

How a Genicular Nerve Block Works

A genicular nerve block is a diagnostic and therapeutic injection performed in the office, typically in under 30 minutes.

1. The skin is cleaned and numbed.
2. Using live X-ray guidance (fluoroscopy) or ultrasound, the physician places a thin needle next to the specific genicular nerves around the knee.
3. A small amount of local anesthetic is injected, temporarily blocking the pain signals from those nerves.
4. You are asked to test the knee — walk, take stairs, do the movement that normally hurts — and track your relief over the next several hours.

That last step is the point. The block is a diagnostic test as much as a treatment. If numbing those nerves produces substantial relief, it confirms that the genicular nerves are carrying your pain, and it identifies you as a strong candidate for a longer-lasting version of the same idea.

From Block to Lasting Relief: Radiofrequency Ablation

When a diagnostic block works well but the relief wears off with the anesthetic, the next step is often genicular radiofrequency ablation. Using the same targets, a specialized needle delivers radiofrequency energy that creates a small, precise lesion on the sensory nerve, interrupting pain transmission for a much longer period — commonly six to twelve months, sometimes longer.

Important, honest framing: this does not repair cartilage and it does not cure arthritis. It reduces the pain signal from an arthritic joint. For many patients, that is enough to restore the daily function they had given up on — and it can be repeated when the nerve regenerates.

We use this same principle throughout the body. Radiofrequency ablation for spinal facet joint pain follows exactly the same logic: confirm the source with a diagnostic block, then treat the confirmed target.

Who Is a Good Candidate?

Genicular procedures are typically considered for patients who:

• Have knee pain from osteoarthritis that has not responded adequately to activity modification, physical therapy, or anti-inflammatories
• Have had partial or short-lived benefit from corticosteroid or viscosupplementation injections
• Are not candidates for knee replacement due to other medical conditions, or are not ready for it
• Have already had a knee replacement but continue to have persistent post-surgical knee pain
• Want to delay surgery while maintaining function

That fourth group surprises people. Persistent pain after a technically successful knee replacement is more common than most patients realize, and it is frequently a nerve-mediated problem rather than a hardware problem.

The Other Options Worth Knowing About

A genicular block is one tool, not the only one. A thorough evaluation usually considers several:

• Corticosteroid injections — useful for reducing inflammatory flares, generally shorter-acting and limited in how often they can be repeated.
• Viscosupplementation — hyaluronic acid injections intended to improve joint lubrication in select patients.
• Platelet-rich plasma (PRP) — uses concentrated components of your own blood to support the joint environment.
• Targeted physical therapy — quadriceps and hip strength meaningfully change the load your knee carries; this is not optional background advice, it is treatment.
• Peripheral nerve stimulation — for select patients with persistent nerve-mediated knee pain.

The right sequence depends on your imaging, your exam, your other medical conditions, and what you are trying to get back to doing.

Healthy Aging Is Measured in Function, Not Comfort

Here is the reframe worth carrying out of Healthy Aging Month. The goal of treating pain in your sixties and seventies is not simply to feel less. It is to keep doing.

The research on this is consistent and a little sobering: reduced mobility in older adults accelerates loss of muscle mass, balance, cardiovascular fitness, and independence. Knee pain that stops you walking does not stay a knee problem for long. Within a year or two it becomes a strength problem, a balance problem, and a fall-risk problem.

Which means treating knee pain is not a comfort measure. It is a preservation strategy. Every month you keep walking is a month you keep the muscle, the balance, and the confidence that let you keep walking next year.

When we talk with patients in Prosper, Celina, and Frisco about goals, the useful ones are always functional and specific: walk the full loop at Frontier Park without stopping. Get through the Prosper farmers market on a Saturday morning. Manage the bleachers at a Friday night game. Get up and down off the floor with a grandchild. Those are better targets than a number on a pain scale, and they are easier to measure honestly.

What to Expect at the Appointment

A first visit for knee pain generally includes a detailed history, a hands-on examination of the knee, hip, and gait, a review of any existing imaging, and a discussion of what you have already tried and how it went. From there we build a plan that starts with the least invasive option likely to help.

Most interventional knee procedures are performed in the office, require no general anesthesia, and allow a return to normal activity within a day or two. Our team will confirm coverage with your insurance beforehand — you can start that process with a benefit verification request.

Chronic Pain Is Not a Requirement of Getting Older

Aches after a long day of yard work are normal. Pain that reshapes your week, shrinks your world, and rewrites what you are willing to plan is not — and it is not something you have to file under “my age.”

Advanced Pain Institute of Texas provides interventional pain care to patients across North Texas, including Prosper, Celina, Frisco, and McKinney. Our board-certified specialists focus on minimally invasive treatments that restore function, not just mask symptoms.

If knee pain has quietly changed what you say yes to, request an appointment. There is usually more room between “live with it” and “replace it” than patients have been told.

This article is for educational purposes and is not a substitute for individualized medical advice. Candidacy for any procedure is determined after an in-person evaluation.