About Joint Denervation
Each joint receives pain signals through a small group of named sensory nerves. Joint denervation maps those nerves with ultrasound and then turns down their signal, most often with radiofrequency ablation and sometimes with cold (cryoneurolysis) or a medication-based approach. The joint's cartilage, bone, and ligaments are not changed.
This approach is most useful for people with long-standing joint pain who are not ready for surgery, want to postpone it, or are not good surgical candidates because of other health conditions. It can also help people who still have pain after a joint replacement.
Dr. Chen performs these procedures under ultrasound so he can see each nerve and the blood vessels beside it. The goal is less pain with walking, stairs, sleep, and exercise, so that you can stay active and keep strengthening the muscles that support the joint.
What happens during treatment
- 1.
A visit with Dr. Chen reviews your history, imaging, and prior treatments, and an ultrasound exam identifies the nerves that supply the painful joint.
- 2.
A diagnostic block numbs those nerves with local anesthetic. You keep a simple pain log for the rest of the day to see how much your usual pain improves.
- 3.
If the block gives clear relief, the denervation procedure is scheduled. Each nerve is numbed, located under ultrasound, and then treated.
- 4.
You go home the same day with guidance on activity and a plan to build strength as pain settles.
Who may be a good candidate
- Adults with moderate to severe arthritis pain in the knee, hip, shoulder, or another listed joint that limits daily activity.
- People who want to delay or avoid joint replacement, or who are not good candidates for surgery.
- People with ongoing pain after a joint replacement once other causes, such as infection or loosening, have been ruled out.
- Anyone who had strong relief from a diagnostic nerve block of the joint.
Recovery
Most people return to normal daily activity within a day or two. Soreness at the needle sites is common for several days. Pain relief usually builds over the following weeks. We encourage a gradual return to walking and strength training during this time, since stronger muscles help protect the joint and extend the benefit.
Risks and limits
Side effects are usually minor: soreness, bruising, and a temporary patch of numbness or skin sensitivity. Less commonly, a treated nerve becomes irritated for a few weeks. Infection and bleeding are rare. Denervation does not slow arthritis, and because nerves regrow, pain can return and treatment may need to be repeated. If your joint is unstable, badly deformed, or mechanically locking, surgery may be the better answer, and we will help coordinate that referral.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about Joint Denervation
- Is joint denervation the same as radiofrequency ablation?
- Radiofrequency ablation is the most common tool used for joint denervation. Joint denervation describes the goal: quieting the nerves of a specific joint. Depending on the joint and your situation, Dr. Chen may use heat, cold, or medication to reach that goal.
- Can I still have a joint replacement later?
- Yes. Joint denervation does not change the joint itself, so it does not prevent a future replacement. Many people use it to stay active and comfortable while they decide on the right timing for surgery.
- Does joint denervation help arthritis heal?
- No. Joint denervation reduces pain by quieting nerves; it does not repair cartilage or change the course of arthritis. It works best alongside strength training and weight management, which help the joint handle daily loads.