Sterile Phenol 6% Perineural Injection PF


phenol 6 percent vial square 500


Concentration = 6%
Vial Volume = 5 mL
Extended BUD

See Also:
Sterile Glycerin 99% Injection PF 


Total Joint Replacement and Phenol (Literature Review)

Total joint replacement is one of the most commonly performed surgeries in the U.S. Each year there are 680,000 total knee replacements (TKR) performed, with TKR projected to grow by 190 percent by the year 2030.(1) TKR is considered a useful and cost-effective procedure for end-stage arthritis. End-stage arthritis causes ongoing pain and diminished quality of life for patients.(1)

“Although TKR is successful in reducing knee pain and joint stiffness in most cases, it can be associated with a 7-35 percent incidence of persistent refractory post-surgical knee pain.”(2) Since the main goal of patients undergoing TKR is to walk freely without pain, the persistent pain is dissatisfying for patients and frustrating for surgeons. Follow-up appointments and treatment also add cost to the health care system.(3)

A study published in the journal Pain Medicine evaluated image-guided chemical neurolysis using phenol to treat chronic knee pain. “All patients experienced profound durable pain reduction and improved function following chemical neurolysis, ranging from five to 12 months of profound pain relief and improved knee function.”(4)

A clinical study currently being conducted at a major university is enrolling 40 participants with chronic knee pain after TKR. The aim of the study is “to determine whether chemical neurolysis of the genicular nerves with 6 percent aqueous phenol is non-inferior in reducing knee pain as compared to corticosteroid injection of the genicular nerves, in patients with refractory chronic knee pain for more than six months after total knee replacement.”(2) 

(1) American Academy of Orthopedic Surgeons, Projected Volume of Primary and Revision Total Joint Replacement in the U.S. 2030 to 2060,
(2) U.S. National Library of Medicine, Phenol Neurolysis of Genicular Nerves for Chronic Knee Pain,
(3) Lim, H. MD, Soong, E. MD, Clinics in Orthopedic Surgery, Causes of Aseptic Persistent Pain after Total Knee Arthroplasty,
(4) Walega, D. MD, McCormick, Z. MD, Pain Medicine, Chemical Neurolysis of the Genicular Nerves for Chronic Knee Pain: Reviving an Old Dog and an Old Trick,


Spasticity and Phenol (Literature Review)


Spasticity is a common motor disorder that can occur following a neurological insult, including stroke, traumatic brain injury, or spinal cord injury.(1) Spasticity can lead to complications such as muscle shortening, postural deformities, and joint contractures.(1)

According to a leading medical association, symptoms of spasticity can range from mild stiffness or tightening of muscles to spasms that can be painful and uncontrollable. Symptoms include: 

  • Muscle stiffness, causing movements to be less precise and making certain tasks difficult to perform
  • Involuntary crossing of the legs
  • Muscle and joint deformities
  • Muscle fatigue
  • Inhibition of longitudinal muscle growth
  • Inhibition of protein synthesis in muscle cells(2)

Spasticity is generally treated with a combination of therapies, including exercises, oral medications, intrathecal therapy (with medicine delivered through a pump and catheter system), injections, and surgery.(3)

Injected spasticity medications, such as phenol and botulinum toxin, block messages sent from nerves to the muscles that tell the muscles to contract. When the messages are blocked, spasticity is reduced, improving function.(4)

A retrospective review of 185 patients with spasticity who underwent phenol neurolysis procedures was conducted at an academic rehabilitation center in the U.S. The phenol preparation used was 6%. “Post-phenol neurolysis assessment was recorded in 54.9 percent of encounters, in which 84.5 percent reported subjective benefit.”(5) The study concluded: “The results revealed that phenol neurolysis may be a useful treatment option for spasticity management in a variety of patients with a plethora of diagnoses. In addition, this extensive utilization of phenol neurolysis was shown to be associated with no serious procedure-related complications and only a small incidence of observed adverse effects.”(5)

Spasticity is a disabling symptom of cerebral palsy, a disorder caused by damage occurring in an immature brain.(6) Spasticity in a person with cerebral palsy can cause pain and progressive muscle shortening.(6) A study of 61 children with cerebral palsy compared phenol 6% with botulinum toxin, in treating spasticity. The study concluded that “the neurolytic block with 6% phenol, when adequately indicated, is a tool that provides excellent cost-benefit relation, high margin of safety, and infrequent complications, especially when administered by a well-qualified physiatrist.”(6)

(1) Karri, J MD., Manuel, F. MD, et. al., Journal of Rehabilitation Medicine, Practice Patterns for Spasticity Management with Phenol Neurolysis,
(2) American Association of Neurological Surgeons, Spasticity,
(3) Mayo Clinic, Spasticity Management for Spinal Cord Injury,
(4) Gillette Children’s Specialty Healthcare, Botulinum Toxin and Phenol (Injected Spasticity Medications)
(5) Karri, J. MD, Manuel, F. MD, Journal of Rehabilitation Medicine, Practice Patterns for Spasticity Management with Phenol Neurolysis,
(6) Gonnade, N. MD, Lokhande, V. MD., et. al., Journal of Pediatric Neurosciences, Phenol Versus Botulinum Toxin A in Injection in Ambulatory Cerebral Palsy Spastic Diplegia: A Comparative Study,


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