Stellate Ganglion Blocks (SGBs) Portland Oregon | NW Regen
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Stellate Ganglion Blocks

Calming anxiety and fear-based responses. Get your life back.

What is a Stellate Ganglion Block (SGB)?

Stellate Ganglion Blocks are precise, ultrasound-guided injections aimed at the sympathetic nerve bundle in the neck. It is a natural, safe methodology that NW Regen couples with compassionate care and a tailored, personal approach to helping patients. 

These life-changing blocks are instrumental in managing a range of mental health conditions, including PTSD, PTSI, anxiety, panic attacks, and depression as well as pain from traumatic brain injury (TBI) and symptoms patients experience from Long COVID by modulating the body’s stress response.

Why is NW Regen the best place for SGBs?

NW Regen is a leader in the field of SGB injection therapy.  Dr. Ryan Wood has specialized in this minimally invasive procedure since 2017 – having completed  2,500+ SGB procedures.  He lectures domestically and internationally, while also providing hands-on physician training globally to those wishing to learn this incredible modality.

 

What might Stellate Ganglion Blocks (SGBs) help with?

Conditions where SGB may offer benefit include:

Stellate Ganglion Block (SGB) is an established block for certain pain and sympathetic nervous system disorders and is being explored as an off-label option for a range of other conditions involving autonomic dysregulation. 

  • Trauma-related anxiety and work-related stress
  • Post-Traumatic Stress Disorder (PTSD/PTSI)
  • Traumatic Brain Injury (TBI) and post-concussive symptoms
  • Long COVID symptoms (espacially fatigue, brain fog, dysautonomia)
  • Chronic Fatigue Syndrome (CFS/ME)
  • Dysautonomia and Autonomic nervous System Imbalance
  • Postural Tachycardia Syndrome (POTS) 
  • Parosmia (distorted smell) and Anosmia (loss of smell), especially post-viral
  • Postpartum mood distrubances (including depression and anxiety)
  • Sleep distrubances and trauma-related nightmares
  • Complex Regional Pain Syndrome (CRPS)
  • Reflex Sympathetic Dystrophy (RSD)
  • Compartment syndrome with autonomic features
  • Causalgia or nerve injury-related burning pain
  • Phantom limb pain
  • Autonomic dysfunction of the head, neck, or upper limb
  • Herpes zoster (“shingles”) involving the face, neck, or upper chest

We integrate SGB with other modalities when indicated, and we individualize care based on the best available research and patient response.

Some of the above uses are considered off-label and investigational. Outcomes may vary. Please consult with your provider to determine if SGB is appropriate for your specific condition.

Why finding experienced experts matters.

It’s about ensuring the utmost accuracy and safety for every patient.

NW Regen is a pioneer and recognized leader in Stellate Ganglion Block (SGB) on the west coast, serving a diverse community of patients from across the US, Canada, and beyond.

We cannot emphasize enough the critical importance of expertise and precision in these procedures. Our extensive experience underscores our commitment and established position as leaders in this field.

Utilizing ultrasound for injection guidance is non-negotiable for us. Adhering to the highest standards of best practice, our team utilizes ultrasound technology — the gold standard for visualizing anatomy, monitoring blood flow, and guiding each injection with the highest level of care.

A recent study of the bilateral two-level cervical sympathetic chain block (2LCSB) followed 75 patients with diagnosed PTSD for six months after receiving 2LCSB. Here’s what they found:

 

  • 96% of patients showed significant improvement
  • On average, PTSD symptoms were reduced by 55%
  • Some trauma types—such as sexual assault and childhood abuse—showed improvement rates over 70%
  • Benefits were long-lasting, not just a temporary fix
First responders

Why working with NW Regen is your best option.

Dr. Ryan Wood

How NW Regen performs SGBs is decidedly unique.

Our process begins with an in-depth, hour-long consultation to review your health history and discuss your needs. This ensures a full understanding of the procedure, what you can expect afterward, and any other concerns you may have.

During each session, we conduct a thorough “Dual Sympathetic Reset” or “DSR,” targeting both the  upper cervical ganglion near C3/C4 and the stellate ganglion near C6/C7  for a more comprehensive procedure than typically offered — while most other clinics focus solely on the C6 level.

Our approach is designed to inform and involve you at every step of the way, ensuring a plan that’s as unique as you are.

Our team supports you before, during and after.

We provide a tailored, personal approach to helping patients, with direct doctor-to-patient consults, special expertise in SGB procedures, and recommendations for additional approaches for post-traumatic stress-related injuries.

Because of our vast experience in this area, we’ve developed a support network of additional practitioners and other resources for a broader spectrum of care.

These specialists will be recommended depending on your particular needs based on your physical conditions and health. This ‘team approach’, combined with the SGB procedure, can be extremely beneficial for post-traumatic-stress injuries.

Stellate Ganglion Block (SGB) FAQs

How do Stellate Ganglion Blocks work?

Stellate Ganglion Blocks (SGBs) have the ability to “reset” the nervous system to a pre-trauma state, similar to rebooting a computer. When we inject an anesthetic (using an ultrasound for visual guidance), it blocks the nerve highway that carries information responsible for triggering fear and anxiety-based responses.

At NW Regen, we use a dual block, or cervical sympathetic blockade, as a more complete block to offer the best evidence-based care of post-traumatic stress. That means we treat the upper cervical ganglion near C3/C4 and the stellate ganglion near C6/C7.

Stellate Ganglion Blocks are effective at creating an immediate reduction in symptoms and a lasting calm that opens up a window of opportunity where other treatments, including behavioral therapies, can provide complete healing.

We often encourage patients to use this treatment as part of a full program with a behavioral health care specialist.

How are Stellate Ganglion Blocks performed?

We cleanse the skin on your neck on either the right or left side depending on where we are performing the injection. Once sterile, we review the anatomy using ultrasound imaging including a Doppler scan of the blood supply to prepare for the injection. Once we isolate the  upper cervical ganglion near C3/C4 and the stellate ganglion near C6/C7, we inject a small amount of anesthetic into the skin to numb the skin. We then slowly inject the anesthetic directly onto the stellate ganglion using a small needle followed with a similar injection at the upper cervical ganglion.

What is Horner's syndrome and how is it connected to SGBs?

A successful SGB can cause a Horner’s syndrome – a group of temporary symptoms “on the side of the injection.” These symptoms will disappear shortly after the anesthesia wears off. Depending on the type of anesthesia used, it may be roughly 45 minutes to 4 hours before symptoms of a Horner’s response go away.

Horner’s syndrome can include drooping of the upper eyelid, constriction of the pupil, appearance of a sunken eye, lack of facial sweating, redness of the white part of the eye, stuffy nose, and/or increased skin temperature on the side of the injection.

 

What effects might I experience from the block?

People experience other symptoms besides a Horner’s Syndrome following a block. These symptoms do NOT affect the outcome of a good block. They are simply the result of an incidental block to other nerves near the stellate ganglion.

Symptoms are temporary and can include trouble swallowing, a lump in the throat, or hoarseness, and they go away just like Horner’s syndrome.

Do SGBs require two visits? What if I'm traveling from out of town?

Our standard process involves two visits with blocks on each day over a short timeframe. Research has indicated that two blocks on two separate visits increases outcomes and is the standard of care for this procedure.

For traveling patients, we do blocks on the morning of Day 1 and the evening of Day 2, or on the evening of Day 1 and the morning of Day 3.

What will I experience later on?
Most patients experience a reduction in anxiety and have a general sense of calm within one hour of the procedure. Occasionally, very few patients experience a delayed response that happens after five days or so.
How long has this procedure been around?
Longer than most people think! It was first used in the U.S. in 1925 to provide relief from chronic pain and then used again for depression in 1945 in The Cleveland Clinic. It was also used to help German prisoners of war recover from their experiences in Russian camps during World War II. However, experts believe it wasn’t used regularly until sometime after 1998.
What do I need to know about payments and billing?

Stellate ganglion blocks are not typically a covered specialty. However, we provide you with superbills that contain a breakdown of procedures performed, all diagnostic coding, and any documentation you may need to submit to your insurance provider.

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