Joint Denervation

Joint denervation is a surgical procedure that treats chronic (ongoing) joint pain. Your nerves send signals from a painful joint to your brain. With joint denervation, surgeons remove the nerves that are transmitting the pain signals, so you no longer feel the pain. 

The procedure only affects the nerves, not the joint itself. Only the pain-transmitting nerves are removed, so you still have normal sensation in your skin and your joint will bend like normal. It’s a common and safe treatment option that’s often used to treat chronic joint pain in your fingers, thumb, wrist or knee. 

Signs of nerve pain from joint problems 

With nerve-related joint pain, you may notice symptoms such as:

• Burning
• Tingling
• Sharp or shooting pain
• Tenderness on the skin covering the joint

Conditions like arthritis, tendinitis, bursitis or past injuries (trauma) can cause this type of pain. It can sometimes be severe enough to wake you up at night. 

When is joint denervation recommended?

Many people try pain medications, anti-inflammatory drugs, creams, injections, exercises and physical therapy first. While these treatments may work for a while, they can lose their effectiveness over time.  

Joint replacement surgery is another option but has some downsides - it’s expensive, requires a longer recovery and carries risks like joint failure or infection. Some people also continue to have pain even after joint replacement. 

Joint denervation might be recommended if: 

• You don’t want joint replacement surgery 
• You aren’t a good candidate due to age or other health conditions 
• You still have pain after joint replacement 

It can also be a good choice for: 

• Younger, active individuals 
• Older or frail adults at higher risk from major surgery 
• People who want a faster recovery compared to joint replacement 

What joints can joint denervation treat? 

Joint denervation is often used to relieve pain in the: 

• Finger 
• Thumb 
• Wrist 
• Hand 
• Knee 

How is nerve pain diagnosed?

Not all types of joint pain can be treated with joint denervation. So your health care provider will want to figure out what’s causing your pain. They may recommend imaging tests like MRIs or X-rays to look closely at your joints and nearby tissues.

If your provider thinks joint denervation might help, they may first recommend a nerve block test. For this test, they inject an anesthetic (numbing medicine) around the nerves to temporarily block them. When the nerves are blocked, you can see how much pain relief you get. If you have little or no pain, it’s likely that joint denervation will help.   

What to expect during joint denervation surgery  

Your health care provider will explain what you need to do before surgery. You may need to avoid all food and drink for eight hours before the surgery. Your provider may also ask you to stop taking certain medications.

During surgery: 

• Surgeons make several small incisions to remove the nerves transmitting pain signals. 
• Nerves that control sensation and joint movement are left untouched. 
• Many patients don’t need general anesthesia. 
• Most people go home the same day. 

Because the procedure is minimally invasive and doesn’t disturb the joint itself, recovery is usually faster than with other surgeries. Most people: 

• Do not need a cast or physical therapy 
• Can use the joint normally soon after surgery 
• Return to regular activities in one to two weeks 

After the surgery, you should find that your pain is gone within three to four weeks and you no longer need to take pain medication. The results are usually permanent. You should be able to do the things you could do before pain made them difficult. 

What are the risks of joint denervation?

Joint denervation surgery has minimal risks. However, as with any surgery, there’s a small chance of: 

• Pain 
• Bleeding 
• Some loss of sensation 
• Persistent pain after the procedure (less common) 

The risk of complications is much lower than with joint replacement surgery. 

Key points about joint denervation

Joint denervation is a minimally invasive surgery that targets nerves causing chronic joint pain. 

• The procedure removes pain-transmitting nerves while preserving normal movement and feeling. 
• It may be a good option for people who want to avoid joint replacement surgery or aren’t good candidates for it. 
• Recovery is typically quick, and most patients experience long-term pain relief. 

If you are considering surgery for joint pain, talk to your health care provider about your options. Together, you can find the right treatment to help you get back to doing the activities you enjoy. 

Meet our doctors who specialize in joint denervation or discuss your needs with your primary care physician.