What is Chronic Knee Pain?

What is Chronic Knee Pain?

Chronic knee pain is pain in or around the knee that persists for more than three months. It is a common and often debilitating condition that can significantly reduce mobility, independence, and quality of life. The pain may be constant or intermittent and is often made worse by walking, climbing stairs, standing from a chair, or prolonged activity.

Chronic knee pain can result from osteoarthritis, previous injury, inflammation, or surgery, including persistent pain following a knee replacement. In some people, the original injury or joint problem has healed, but the nervous system continues to amplify pain signals—a process known as central sensitisation. As a result, pain may persist despite medications, physiotherapy, or orthopaedic treatment.

Many people referred to Pain Clinic NI have experienced symptoms for months or years and have not achieved satisfactory relief despite appropriate conservative management or orthopaedic interventions. Our role is to identify the underlying pain mechanisms and explore additional evidence-based treatment options to improve pain, function, and quality of life.

Common Symptoms

Depending on the cause, you may experience:

  • Aching, sharp, or throbbing pain around the knee joint
  •  Swelling or stiffness
  • Difficulty bending, straightening, or bearing weight
  • Clicking, locking, or a feeling of instability
  • Pain that worsens with walking, stairs, or prolonged sitting

Diagnosis

A full clinical assessment is the first step and includes:

  • Detailed history of your symptoms and activity levels
  • Physical examination of knee mobility, strength, and stability
  • Imaging such as X-ray, ultrasound, or MRI, when needed to confirm diagnosis or rule out serious conditions

Treatment Options for Chronic Knee Pain

We specialise in two key interventional treatments:

1. Knee Genicular Nerve Block

This is a diagnostic and therapeutic injection of local anaesthetic (and sometimes steroid) around the knee (genicular) nerves.
It is used to:

  • Confirm whether the genicular nerves are the source of pain

  • Provide temporary pain relief

  • Guide the suitability and selection of the right patient for longer-lasting treatment (RF)

What to expect:

  • Performed under X-ray or ultrasound guidance
  •  Takes 15–30 minutes
  • You remain awake throughout
  • Pain relief may last hours to weeks

If the block provides good short-term relief, you may benefit from longer-lasting radiofrequency treatment.

2. Knee joint Radiofrequency Denervation (RF)

This is a minimally invasive procedure that uses a controlled electrical current to heat and kill the genicular nerves, reducing their ability to send pain signals.

  • Conventional RF (heat-based lesioning) for long-lasting relief

Benefits:

  • Significant pain reduction may be achieved in well selected patients
  • Improved knee function and mobility
  • Helps to restart rehabilitation, hydrotherapy and other self management strategies.
  • May delay or reduce the need for surgery
  • Minimally invasive with low risk
  • Typically lasts 6–12 months 

Who is This Treatment For?

You may be a candidate for genicular nerve treatments if you have:

  • Mild to Moderate knee osteoarthritis
  • Ongoing knee pain after knee replacement surgery
  • Chronic knee pain unresponsive to medication, injections, or physiotherapy
  • Limited surgical options or a wish to avoid further surgery

These procedures are often used when traditional treatments have not provided lasting relief.

 

What to Expect

With accurate diagnosis and the right combination of treatments, most people experience significant improvement in pain and function.

For chronic cases, improvement may take several weeks and require commitment to rehabilitation and activity adjustments.

When to Seek Help

You should see a healthcare professional if:

  • Knee pain lasts longer than 2–3 weeks
  • Pain interferes with walking, sleep, or daily function
  • There is noticeable swelling, locking, or instability
  • You have a history of trauma or known arthritis