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Nerve Treatments for Arthritis Pain

Stopping nerves from transmitting signals may be one option for pain relief.

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Have you tried many medication, nondrug and lifestyle to treat your arthritis pain? Are you delaying joint surgery for as long as possible or trying to avoid it altogether? You may consider a treatment that deadens the pain signals being sent from your damaged joints to your central nervous system for pain relief.

Nerve treatment can help ease pain but  won’t change your underlying arthritis or slow disease progression. Here are four options to discuss with your doctor or a pain specialist.

Radiofrequency Ablation or Neurotomy

What it is: An insulated needle is inserted next to a nerve in the knee or facet joints ( paired joints of the spine). High-frequency energy is transmitted through the needle. This heats up and damages the nerves, interrupting pain signals. The procedure can provide relief until the nerves regenerate. This could last up to a year, but how much relief you feel and how long it lasts will vary from person to person.

Pain it works well for: This therapy is useful if you have osteoarthritis in the facet joints or knees. A 2017 study published in Regional Anesthesia and Pain Medicine found that radiofrequency ablation of the knee provided longer-lasting pain relief than steroid injections.

Risks: In rare instances, you can have numbness, infection, bleeding or a temporary increase in pain.

Cryoneurolysis

What it is: A tool that contains liquid nitrous oxide freezes three small, hollow needles. These needles are inserted into or near a joint. The cold damages pain-causing nerves, providing relief from your arthritis pain. After a few months, the nerve regenerates and pain will begin to return.

Pain it works well for: The procedure is done in the knee and facet joints of the  back . You’ll have greater pain relief that lasts longer if your arthritis is mild. A 2016 study published in Knee found that people who received cryoneurolysis several days before surgery recovered faster and needed fewer narcotic pain relievers after joint surgery.

Risks: Side effects are mild and include bruising, tenderness and swelling at the injection site.

Nerve Block

What it is: A doctor injects a local anesthetic, such as lidocaine -- or a mixture of a numbing agent plus a corticosteroid -- into a nerve. The anesthetic stops pain signals from traveling to the brain, and the steroids help reduce inflammation. Nerve blocks are used to temporarily block pain and to help physicians pinpoint where pain is coming from.

Pain it works well for: Nerve blocks are most commonly used for back pain that radiates down into the arm or leg. Depending on your level of pain, a nerve block may provide immediate relief. For people who have had longstanding pain, it may take a series of injections before it helps.

Risks: Infection and bleeding can happen with any injection. It’s possible that a physician could target the wrong nerve, which could lead to problems with movement or feeling in the area affected.   

Intrathecal Pain Pump

What it is: A small pump filled with pain medication, such as morphine, is surgically implanted into the body. The pump delivers programmed amounts of medicine directly into the space around the spinal cord. This localized medicine comes with fewer system-wide side effects than oral narcotics.

Pain it works well for: Pain pumps are most commonly used for spine disorders such as compression fractures or spinal stenosis. It can also can be used for rheumatoid arthritis or connective tissue disorders, but is usually as a last resort.

Risks: As with any surgery, there are risks of infection and bleeding. And it’s possible the drug-delivery catheter could get blocked. Implanted pumps need to be refilled every 1 to 3 months.

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