Stellate Ganglion Block

Pain presenting in the head, neck, arms, or chest can be the result of a number of conditions involving the stellate ganglion nerves. These conditions include phantom limb pain, shingles, and even complex regional pain syndrome (CRPS). A stellate ganglion block is one treatment for such conditions. It works to calm the nerves and interrupt pain signals.



The stellate ganglion is part of the sympathetic nervous system. It is located in the neck, in the general area of the voice box. Despite the ganglion’s delicate location, this block procedure is safe and efficacious. It is an outpatient procedure that can usually be completed in about 30 minutes.


How the Procedure Is Performed


Patients lie on their backs for this procedure. Because of the location of the treatment site, doctors prefer to administer an IV medication to help the patient relax. Shortly thereafter, the skin at the injection site is treated with a local anesthetic. The anesthetic will also numb the tissue all the way down to the ganglion nerves.


A fluoroscope is used to determine the best site for the medication. Therefore, the first injection is that of a contrast dye that facilitates fluoroscopy. Once the correct site has been chosen, the doctor injects a combination of medications that include an anesthetic, an anti-inflammatory, and a saline solution.


Anesthetic works almost instantly to block pain signals headed to the brain. Meanwhile, the anti-inflammatory drug begins working to reduce inflammation. Its full effects are generally not until a day or two after the procedure. Following the injection, the needle is removed and the area bandaged.


Patients will require a few minutes of monitored recovery time. Doctors may recommend patients avoid driving or stressful activity for at least for 24 hours. Patients can return to normal activity thereafter, as they see fit.


What Patients Can Expect


In the moments immediately following injection, patients may experience a warm, tingling sensation in the arms and hands. Nasal congestion, bloodshot and droopy eyes, and temporary hoarseness are expected. These side effects generally wear off after a few hours.


In terms of long-term pain relief, stellate ganglion block offers pain relief for several days to several weeks. However, there is a caveat. If the first injection proves successful, doctors are more likely to recommend additional injections. The length of time during which pain relief is experienced tends to increase with each subsequent injection.


There is no way to know for sure how many injections a person will need to realize the targeted level of pain relief. Some patients get by with two or three, others need more. The key is the first injection. If it works, the doctor’s initial diagnosis was probably correct.


Note that this procedure is sometimes used as a way of figuring out what is causing a patient’s chronic pain. If the initial injection doesn’t help, doctors have to go back and look for another cause.


Complications and Side Effects


Stellate ganglion block is a safe procedure with low risk of serious complications. Minor side effects are those already mentioned, along with pain and swelling at the injection site and difficulty swallowing. Though rare, serious complications include infection and bleeding.


If you would like to know more about whether or not stellate ganglion block is appropriate for you, please make an appointment to see one of our pain doctors.