Stellate Ganglion Block

For patients who are experiencing pain in the upper extremities and have yet to find relief, a stellate ganglion block might be the solution. Where there are several injection options available that treat specific conditions, a stellate ganglion block targets a collection of nerves that are responsible for providing sensations throughout the head, neck, chest or arms. This treatment option provides patients with not only pain relief, but an important diagnostic tool that helps to find long-term relief. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas is dedicated to helping their family of patients finally find relief, and are experts at providing stellate ganglion blocks as an effective method to do so. 

What are Stellate Ganglion Blocks?

A stellate ganglion block is an injection of medication into a collection of nerves at the bottom of the front side of your neck, at the sides of your voice box. The stellate ganglion is a collection of nerves located near the collarbones. It is shaped like an oval but could also look like a star, hence “stellate,” which means star. What makes this collection of nerves so important is that it provides the majority of the sympathetic nerve signals to the head, neck and arms, as well as a portion of the upper chest. 

The sympathetic nervous system is part of the autonomic nervous system, which is responsible for the functions that the body controls without the brain having to regulate them. This includes heart rate, blood pressure, sweating and more. 

The stellate ganglion is responsible for delivering many sensations – pain and otherwise – to the brain, so when these nerves are injured or experiencing duress, the sensation that is delivered is pain. This is where a stellate ganglion block comes in. The block helps to relieve pain, swelling, sweating, poor circulation and lack of mobility in the upper extremities. 

In addition to providing pain relief and function improvement, stellate ganglion blocks can also be used as a diagnostic tool. If the block helps to provide relief, it confirms that the stellate ganglion is the cause of pain. But there are other outcomes as well, including: 

• The feeling of pain is not relieved but other symptoms are, meaning that the cause of pain is not related to the stellate ganglion
• The pain is not addressed, and other symptoms still occur
• Pain and symptoms resolve – success!

What Do Stellate Ganglion Blocks Treat?

Due to the fact that the stellate ganglion is responsible for sensations felt throughout the upper body, there are a myriad of conditions that ganglion blocks are helpful for treating. Pain management specialists most often use stellate ganglion blocks to diagnose or treat nerve injuries or issues with circulation. These include: 

• Complex regional pain syndrome (CRPS): a neurological condition that causes pain and other symptoms in your extremities
• Reflex sympathetic dystrophy syndrome (RSD): a disorder that causes lasting pain, usually in an arm or leg, and causes severe pain after an injury, stroke, or even heart attack 
• Sympathetically mediated pain (SMP): a chronic neuropathic pain condition that happens when your sympathetic nervous system sends pain signals to your brain for unknown reasons
• Phantom limb pain: pain that is felt after a limb loss (amputation) where residual limb pain is experienced in the remaining part of the limb
• Chronic post-surgical pain
• Post traumatic stress disorder
• Shoulder/hand syndromes
• Nerve injury
• Poor circulation in the upper extremities
• Excessive sweating in the face and upper extremities
• Hot flashes and sleep dysfunction
• Scleroderma: an autoimmune disease that causes inflammation and thickening in the skin and other areas of the body
• Shingles
• Raynaud’s Syndrome: spasms in small blood vessels in your fingers and toes
• Intractable angina: a condition in which patients of heart disease continue to suffer from recurrent restricting angina, even though they are following the right medication plan
• Cluster headaches
• Orofacial pain: pain perceived in the face and/or mouth
• Refractory cardiac arrhythmias: a malfunction of the heart’s normal pumping sequence
• Depression, anxiety and psychosis (a collection of symptoms that affect the mind, where there has been some loss of contact with reality)

Most patients are able to experience near or complete pain relief with a stellate ganglion block. Others can experience partial relief, and might find enhanced relief with a series of stellate ganglion blocks over a recommended period of time. The provider can also deliver a precise combination of medication to treat the patient’s symptoms and level of pain. 

What Does a Stellate Ganglion Block Procedure Involve? 

A stellate ganglion block procedure is a minimally-invasive procedure that is performed in a doctor’s office, with or without the need for IV sedation. The patient will lie on their back, face up, and the provider will clean and disinfect the neck area before injecting a local anesthetic into your neck near your voice box, which numbs the area. The provider will then use fluoroscopic imaging guidance to insert a second needle, which delivers an anesthetic medication into the targeted area. 

The entire procedure takes about 30 minutes. Some patients report feeling immediate pain relief after the injection, but the pain could also return once the local anesthetic wears off. Other patients have longer-term relief that allows them to both reduce their medication dependency as well as increase their physical therapy efforts. 

Pain relief varies from person to person, but could last from days to weeks. Most patients require a series of injections to lengthen the duration of pain relief. The good news is that the relief experienced increases with each injection. 

What are the Risks of Stellate Ganglion Blocks?

Stellate ganglion block is a low-risk, non-surgical treatment and recovery is generally simple. While side effects are short-lived and minor, the most notable post-operative symptoms include: 

• Red eyes
• Difficult swallowing, or the feeling of a “lump” in the throat
• Collapsed lung
• Shortness of breath
• Allergic reaction
• Weakness or numbness in the upper extremities
• Esophageal puncture
• Bleeding
• Nerve injury

Stellate ganglion blocks are an effective treatment method for numerous conditions, so if you’re experiencing chronic pain in the upper extremities, reach out to the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas today. Our team of dedicated pain management specialists is able and willing to help you finally find long-lasting pain relief and increase your quality of life.