Stellate Ganglion Blocks

Calming anxiety and fear-based responses.

What are Stellate Ganglion Blocks? (SGBs)

Precise ultrasound-guided injections that target a collection of nerves in the neck and block impulses that trigger fear-based responses like Post Traumatic Stress Disorder (PTSD), insomnia and anxiety. Symptoms are often relieved in as little as 30 minutes and can last for years.

What Conditions Do They Treat?

Anxiety and PTSD
Work-related stress
Long COVID symptoms
ME/CFS
Dysautonomia
POTS
Parosmia
Anosmia
Sleep problems and nightmares
Postpartum depression
Complex regional pain syndrome or reflex sympathetic dystrophy
Compartment syndrome
Causalgia from nerve injuries
Autonomic dysfunction of the upper extremity
Herpes zoster infection (or “shingles”) affecting the head, neck, arm or upper chest
Phantom limb pain

Who else could benefit from SGB?

C-suite executives facing high stress levels may also benefit from SGB, improving strategic decision-making under stress.

How does it work?

Stellate Ganglion Blocks have the ability to “reboot” 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.

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

Frequently-Asked Questions

How are Stellate Ganglion Blocks performed?

We cleanse a small area on your neck on either the right or left side at the level of the C6 vertebrae. Once we isolate the stellate ganglion using ultrasound as a guide, we inject a small amount of anesthetic into the skin to numb the area prior to injection. Then we slowly inject the anesthetic directly onto the stellate ganglion using a small needle.

What will I experience right after the injection?

A successful SGB causes a Horner’s syndrome – a group of temporary symptoms that show that the procedure was done correctly. 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 increased skin temperature on the side of the injection. These symptoms will disappear shortly after the anesthesia wears off.

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 often do I need to repeat the injections?

Our standard treatment involves two injections within 10 to 14 days. The first injection resets the nervous system, and the second injection builds upon the first dose to improve results for most patients. For some conditions like reflex sympathetic dystrophy or complex regional pain syndrome, we perform this procedure weekly for up to six to eight weeks. Some patients also benefit from additional injections several months later.

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.

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