Joint pain affects many people, with degenerative (osteo)arthritis being especially common. As the population ages, more individuals experience joint degeneration and wear-and-tear, causing pain with both movement and rest. Fortunately, there is no need to resign oneself to suffering: today, both conservative and invasive treatments are available to relieve joint pain of varying severity.
Nerve Ablation to Reduce Pain
Physical therapy, medications, and joint injections are commonly used for joint pain. While traditional non-steroidal anti-inflammatory drugs (NSAIDs) are effective, long-term use of older analgesics can place significant strain on the kidneys and stomach. Newer COX-2 inhibitor NSAIDs have fewer side effects but may still be inadequate for severe joint pain. Dr. Lee Yuk Ming, Sunny, a pain medicine specialist, notes that if conservative measures fail, some patients may require joint replacement surgery. However, joint replacement is not suitable for everyone—factors such as serious chronic illnesses or poor healing capacity may preclude surgery—making nerve ablation a timely option to eliminate pain.
Nerve ablation can address pain in the knee, hip, and shoulder joints by using a fine, heated needle to ablate the sensory nerves involved in pain transmission, thereby removing the sensation of discomfort. The advantages are that it is non-surgical and targets only sensory nerves. Prior to the procedure, doctors perform local anesthesia around the sensory nerves near the painful area to assess the analgesic effect of ablating those nerves; with accurate pre-assessment, the treatment can focus on the pain-generating pathways, with a very low risk of affecting motor nerves, making it relatively safe and effective. Another option is pulsed radiofrequency (PRF) therapy; Dr. Lee explains that PRF operates at lower temperatures and is often used for neuropathic or hypersensitive pain conditions, whereas thermal nerve ablation is preferred for joint pain caused by degeneration.
Choosing the Right Treatment for Each Case
Dr. Lee does not recommend ablating all sensory nerves around a painful joint, as complete loss of sensation would prevent the body from receiving protective signals; patients might fail to notice impacts or overstretching, which is not beneficial. In addition, areas where sensory and motor nerves run close together may be unsuitable—for example, behind the knee where these nerves are in proximity—so nerve ablation typically targets the front of the knee. After treatment, some mild pain may persist in the area, but the overall pain level is substantially reduced.
Although the risks of bacterial infection and motor nerve involvement are low, nerve ablation is still an invasive procedure; while it can improve pain, it may not address other degenerative issues such as joint deformity or structural instability. The ablated nerves gradually regenerate over about a year, and pain may recur after some time. If joint pain becomes intolerable, patients—following medical evaluation—may consider repeating nerve ablation approximately every few years.
Information provided by Pain Medicine Specialist Dr. Lee Yuk Ming, Sunny
