FAQ’s on Stellate Ganglion Nerve Block

What is a Stellate Ganglion Nerve Block?

The stellate ganglion (nerve bundle) is part of the sympathetic nervous system and is located behind and on each side of trachea. This ganglion provides sensation to the majority of the upper body and to portions of the face. When the sympathetic nerves of the ganglion are adversely affected, a nerve block can potentially provide relief by numbing them. Patients who are experiencing pain in their arms, torso, neck, or face may be able to achieve some degree of relief through the use of this nerve block.

What will a Stellate Ganglion Nerve Block treat?

Stellate ganglion nerve blocks are used primarily in the treatment of upper extremity pain and to a lesser degree in some areas of the face. They are mostly used as a treatment method for patients with circulatory problems such as uncontrolled sweating, temperature change, and discoloration of the skin. Specific conditions resulting from sympathetic nervous distress include Reflex Sympathetic Dystrophy, Complex Regional Pain Syndrome, shingles, and sympathetic maintained pain.

These nerve blocks have also begun to be used in the treatment of allodynia, which is a pain response to stimuli that would otherwise not be painful (such as being touched by a feather). Allodynia is a sign of central sensitization, where inflammation in the local tissue sends an excess of signals to the central nervous system. These signals are interpreted as pain signals, and the body reacts accordingly. A block into the stellate nervous tissue may help to alter the response of the central nervous system to these stimuli, reducing or preventing the signals of pain sent to the brain.

How is a Stellate Ganglion Nerve Block performed?

The majority of patients will be administered IV sedation to make their procedure a comfortable experience. The average block takes no more than 15 minutes to perform, with the patient monitored throughout and after to ensure there are no negative reactions to the medications used. Patients are commonly asked to remain in a seated position to assist in the spreading of anesthetic.

There are two types of stellate ganglion nerve block that can be administered to a patient: Diagnostic and Therapeutic. Diagnostic nerve blocks use only a small amount of numbing agent, and are performed so that the physician may examine the effects of the procedure on the patient. If a reasonable amount of Pain Relief is obtained through a diagnostic block, a therapeutic block may be given. This is the full amount of numbing agent, often with a steroidal sub-component used to extend the duration of relief for the patient.

How well do Stellate Ganglion Nerve Blocks work?

Full relief for sympathetic pains is achieved through a series of injections for the patient, with each injection slightly more effective than the previous ones. The number of injections required to obtain full relief will vary from patient to patient, with some patients needing as few as two and some patients needing as many as ten.

Each patient will differ in their response to these injections. Patients who receive this treatment closer to the appearance of their symptoms tend to respond much better than patients who have had symptoms for a prolonged period of time.

What are the risks of a Stellate Ganglion Nerve Block?

There is very little risk present with a stellate ganglion nerve block. The largest risk the patient faces is the chance of pain or swelling at the site of injection, and the possibility of an allergic reaction to the medications used. There is a rare chance that the needle will be misplaced and the anesthetic will be injected into an unintended part of the neck, but this is largely prevented through the use of fluoroscopic imaging during injection (a process that uses a series of X-rays to create a current picture of where the needle is during the injection).