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Stellate Ganglion Injection

What is a Stellate
Ganglion Block?

The stellate ganglion is part of the sympathetic nervous system that is located in your neck, on either side of your voice box. A stellate ganglion block is an injection of medication into these nerves that can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

A stellate ganglion block is used to diagnose or treat circulation problems or nerve injuries, including:

  • Reflex sympathetic dystrophy
  • Phantom limb pain
  • Causalgia
  • Complex Regional Pain Syndrome type I or II
  • Herpes zoster infection (or “shingles”) affecting the head, neck, arm or upper chest

    How Long Does the Pain Relief Last?

    Some patients report pain relief immediately after the injection, but the pain may return a few hours later as the local anesthetic wears off. Other patients have longer term relief that outlasts the duration of the local anesthetic and helps them to reduce their medication use and increase their participation in physical therapy.

    How long the pain relief lasts is different for each patient. Some may be pain-free for days or weeks. Usually people need a series of injections to continue the pain relief. Sometimes it takes only two injections; sometimes it takes up to ten. The relief tends to last longer with each treatment.

    What Happens After the Procedure?

    Do not drive or do any rigorous activity for 24 hours after your stellate ganglion block. You can return to your normal activities the next day. When your voice returns to normal, you may begin to sip water through a straw and gradually work up to eating solid foods.

    What are the Risks?

    The risk of complications from a stellate ganglion block is very low. However, there could be bruising or soreness at the injection site. Serious complications, including infection, bleeding and nerve damage, are uncommon.

    Side effects of the procedure may include: drooping eyelids, red or “bloodshot” eyes, tearing, nasal stuffiness, hoarse voice, feeling of a “lump” in your throat, difficulty swallowing, and warmth or tingling in your arm or hand.

    These effects will subside within a few hours.

    Conditions Stellate Ganglion Nerve Block Treats

    Stellate ganglion blocks can help treat a range of nerve injuries and circulation problems, such as:

    • Cluster headaches
    • Migraines
    • Complex regional pain syndrome
    • Phantom limb pain
    • Hyperhidrosis
    • Raynaud’s syndrome
    • Chronic post-surgical pain
    • Peripheral vascular (artery) disease
    • Herpes zoster infection
    • Postherpetic neuralgia
    • Orofacial pain
    • Intractable anginas
    • Refractory cardiac arrhythmias

    Before having a stellate ganglion block, you’ll need to undergo an initial consultation with one of our physicians. During this appointment, they will extensively discuss your medical history and symptoms and, if needed, refer you for diagnostic imaging tests. From there, they will recommend the best treatment for your condition.

    Stellate Ganglion Block Procedure

    Following a preliminary consultation and briefing, our physicians will schedule an appointment for your stellate block. Before the day of the procedure, they’ll likely advise you to fast and stop taking certain medications, such as blood thinners, to reduce the risk of complications.

    Then, on the day of the procedure, they will:

    1. Place you on an examination table on your back.
    2. Clean your neck for incision and administer a local anesthetic to numb the skin to ensure you feel no pain.
    3. Using fluoroscopy, an x-ray that submits images in real-time, they will ensure the needle is accurately placed.
    4. They will then insert the needle through your skin and tissues to reach your stellate ganglion.
    5. A contrast dye may be injected to confirm the needle is in the right place, and the medication will effectively spread to your stellate ganglion.
    6. After confirmation, the medication is injected, typically a local anesthetic and corticosteroid.

    After the procedure is complete, you may be kept in the clinic for 30-60 minutes afterward to ensure you feel no side effects or adverse reactions. It’s important to follow the instructions given by your physician and also not drive afterward due to the temporary numbness you may feel.

    Many patients report feeling immediate relief after the injection. However, it’s also normal to experience some mild pain a few hours following the procedure as the local anesthetic wears off. Often, the pain relief can last for days or weeks. However, if it subsides quickly, you may need a further injection.


    Is a Stellate Ganglion Block Used for Numbness?

    While a stellate ganglion block can help alleviate pain, it is not specifically intended to address numbness as its primary goal. However, in some cases, the reduction of pain and inflammation resulting from the block may also lead to a reduction in associated numbness or tingling sensations.

    How Long Does a Stellate Ganglion Nerve Block Work?

    The effectiveness of a stellate ganglion can vary for each patient. Usually, the effects take just a few hours to notice and can last for weeks. Typically, the more injections you have, the longer the duration of relief.

    What Is Stellate Ganglion Block for Psychiatric Disorders?

    There's growing research that suggests a stellate ganglion block may treat depression, anxiety, and PTSD. This is because it helps reset the "fight or flight" response.

    Updated on Jun 7, 2024 by Dr. Thomas Stauss (Pain Management) of Pro Spine & Pain

    Thomas Stauss, MD

    Thomas Stauss, MD, completed both his undergraduate and medical studies at the esteemed University of Wisconsin in Madison. Dr. Stauss values having access to a wide array of cutting-edge treatments, ensuring effective relief for his patients' discomfort and a significant enhancement in their quality of life. Dr. Stauss’s primary objective is to uphold the dignity of each patient while delivering ethical and professional services.

    More about Dr. Stauss