Pain Management Procedures
Stellate Ganglion Block
Stellate Ganglion Block
What is a stellate ganglion block?
The stellate ganglion is part of the sympathetic nervous system in the lower neck. A block places local anesthetic beside it to temporarily reduce sympathetic nerve activity to the head, neck, upper chest, and arm. It is an established diagnostic and treatment tool for selected sympathetically maintained pain conditions, especially complex regional pain syndrome, or CRPS, affecting an upper limb.
What else has it been studied for?
Stellate ganglion block has also been studied for post-traumatic stress disorder, long-COVID symptoms, brain fog, POTS, anxiety, and depression. These uses are off-label or emerging. Evidence is mixed or limited, and the procedure should not be presented as an established cure or as a replacement for standard medical or mental-health care. Patient selection, realistic goals, and coordination with the clinicians treating the underlying condition are essential.
What happens?
You lie on your back with your neck slightly extended. Ultrasound or fluoroscopy guides a needle beside the sympathetic chain while avoiding the thyroid, airway, blood vessels, and nearby nerves. After careful confirmation, local anesthetic is injected. Monitoring before and after the block is important.
What should I expect?
A temporary droopy eyelid, smaller pupil, warm face or arm, hoarse voice, stuffy nose, or feeling of a lump in the throat can indicate that the block has taken effect. These changes usually fade as the anesthetic wears off. Do not eat or drink until swallowing is normal, and follow the driving instructions provided.
Important risks
Risks include bleeding, infection, medication reaction, seizure or heart effects from injection into a blood vessel, nerve injury, collapsed lung, or accidental spread around the spinal cord. Trouble breathing, severe neck swelling, persistent weakness, or difficulty swallowing requires urgent care.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.