Nerve Blocks & Injections

Stellate Ganglion Block (SGB)

A sympathetic nerve block in the neck that interrupts pain signals from the head, face, upper arm, and chest, with emerging applications for PTSD and vasomotor symptoms.

Nerve

Procedure Overview

Upper extremity CRPS, sympathetically-mediated head and neck pain, and certain persistent pain conditions following surgery or nerve injury are driven by the sympathetic nervous system. The stellate ganglion, a bundle of sympathetic nerves in the neck, is often the gateway. Blocking it can interrupt the pain cycle and, in some cases, produce relief that outlasts the anesthetic by weeks or months.

Treatment Purpose

A stellate ganglion block injects local anesthetic into the stellate ganglion, a bundle of sympathetic nerves in the neck near the base of the voice box. Blocking it interrupts sympathetically-mediated pain pathways affecting the head, face, neck, upper arm, and chest, and improves circulation to the upper extremity. Emerging research also supports its use for PTSD and persistent vasomotor symptoms such as hot flashes.

Appropriate Conditions

Complex Regional Pain Syndrome (CRPS) of the upper extremity
Sympathetically-mediated pain
Raynaud's phenomenon
Post-herpetic neuralgia in the head and neck
Phantom limb pain
Vasomotor instability

Patient Considerations

The procedure is performed under fluoroscopic or ultrasound guidance so the needle is placed with precision. It takes 15 to 30 minutes on an outpatient basis. You will be monitored for 30 minutes afterward. Temporary effects such as a drooping eyelid, nasal congestion, and voice hoarseness are expected, and all resolve within hours as the anesthetic wears off. These are signs the block is working.

Treatment Process

You will lie on your back with your head turned to the side. Under fluoroscopic or ultrasound guidance, a thin needle is carefully advanced to the stellate ganglion in the neck and local anesthetic is injected. The procedure takes 15 to 30 minutes. You are monitored for 30 minutes following the procedure before going home. A series of injections typically produces progressively longer-lasting results.

Frequently Asked Questions

How long does relief last?

Some patients experience days of relief, others weeks. A series of injections typically produces progressively longer-lasting results.

What temporary effects should I expect?

Common temporary effects include a drooping eyelid (Horner's syndrome), nasal congestion, and voice hoarseness. All resolve within hours as the anesthetic wears off.

What are the risks?

With imaging guidance, serious complications are rare. Risks include accidental intravascular injection, infection, or temporary neurological effects.

Medical disclaimer: This page provides general information and is not medical advice. It does not replace an evaluation by a qualified physician. Talk with a doctor about your specific condition and treatment options. If you are experiencing a medical emergency, call 911.

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