Stellate Ganglion Block

BRMC Treating Patients in North Central Arkansas & South Central Missouri

A stellate ganglion block is a procedure whereby we inject local anesthetic into the stellate ganglion. This part of the anatomy is a cluster of nerves situated in your neck between the collar bone and jaw. A stellate ganglion block is a brief, minimally invasive procedure that has the potential to treat a vast range of medical conditions with relatively little risk. This procedure can provide pain relief in the chest, upper extremities, and face, improve circulation in the face and upper body, lessen perspiration in the face and upper body, lessen hot flashes and sleeping problems, and potentially help lessen the effects of PTSD.

Several medical conditions that are commonly treated using stellate ganglion blocks include:

  • Vascular complications in the upper limbs
  • Reflex Sympathetic Dystrophy
  • Hyperhidrosis – excessive perspiration in the face and upper body
  • Herpetic Neuralgia – nerve pain felt after shingles
  • Raynaud’s Phenomenon – when blood vessels in the hands and feet narrow due to the cold
  • CPRS – complex regional pain syndrome –sympathetic pain that occurs when there is an injury and at times when there is not

The Procedure

On the day of your scheduled appointment, please arrive at least 20 minutes early. Our skilled nurses will begin an IV if you want to be sedated and then they will conduct a nurse pre-operation assessment. Afterwards, they will lead you to the procedure room where you will lie down on the hospital bed. Once you are situated and comfortable, our nurses will provide you with sedation in order to make you even more comfortable. At this point in the procedure, we place a cold cleaning solution on all our patients to lessen the risk of infection. Using x-ray guidance, our doctor will identify the procedure site and inject numbing medicine to decrease the feeling on your skin. This injection may sting slightly but the pain is minimal and will pass quickly. Using x-ray guidance again, our doctor will place the spinal needle into position and inject dye in order to confirm that the needle was situated properly. Then, medication comprised of a steroid and local anesthetics will be injected into the procedure site, covering the affected nerves entirely. Many patients reported feeling instant pain relief. The doctor will remove the needle and you will be directed to a recovery room for a brief observation period. The procedure in its entirety only takes about 15 minutes and the recovery period will only be about 15 minutes more. Then, you will be released and free to recover in the comfort of your own home.

What to Expect Afterward

In your upper extremities, you may notice a warm feeling. This is expected and natural. You may also notice that your pain levels have decreased and you have increased functionality in your upper extremities. We advise most patients to take it easy and recover for the rest of the day but you are free to engage in physical, day-to-day activities whenever you feel ready. The pain relief from this procedure may last from a couple days up to several months. For some patients, repeat injections are needed for long term pain relief. This safe and effective procedure is simply repeated as above if a patient needs more injections. After the procedure, physical therapy is typically prescribed in order to restore full functionality and range of motion to your upper extremities. Physical therapy is a very important step to take immediately after the procedure if you want to fully benefit from the effects of the injection.

Risks of the Procedure

Stellate ganglion blocks are widely considered to be a safe, effective, and noninvasive method of pain relief. The procedure has been perfected over the past several decades and the risks are low. However, they can include a misplaced needle, infection, bleeding, a collapsed lung, nerve damage, punctured surrounding organs, punctured blood vessels, allergic drug reactions, and/or paralysis. Fortunately, these are exceedingly rare.

To learn more about stellate ganglion blocks, please call Interventional Pain Management, a department of BRMC, at (870) 508-5900.