stellate ganglion block

FAQ’S ON STELLATE GANGLION NERVE BLOCK INJECTIONS

WHAT IS A STELLATE GANGLION BLOCK?

This is an injection of numbing medicine and steroid into an area of the neck for the treatment of sympathetic related pain in the face, chest, or arms. The treatment may decrease pain, perspiration and hot flashes while improving circulation and sleep patterns.

The injection typically has two purposes. The first is to diagnose that the sympathetic nerves are causing the symptoms, and the second purpose is to provide symptomatic relief.

WHAT EXACTLY IS THE STELLATE GANGLION?

A ganglion is a collection of nerve cells. The stellate ganglion is located just in front of the lowest cervical (neck) vertebra and is a group of nerves that are part of the sympathetic nervous system. After an illness or injury, the sympathetic nervous system may not function properly and be on overdrive, causing pain and symptoms that are very annoying such as hot flashes or burning pain in the arm.

FOR WHAT CONDITIONS IS STELLATE GANGLION BLOCK EFFECTIVE AS A TREATMENT?

An example of Raynaud’s Phenomenon. Person suffers from vascular constriction which leads to decreased blood flow to the hands.

There are quite a few conditions showing benefit from Stellate Ganglion injections:

Complex Regional Pain Syndrome (CRPS)
Reflex Sympathetic Dystrophy (RSD)
Herpes Zoster pain (Shingles)
Phantom Limb Pain
Raynaud’s Phenomenon
Scleroderma
Angina and arterial insufficiency
Hot Flashes
Hyperhidrosis
Posttraumatic Stress Disorder (PTSD)

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How is the procedure performed?

A stellate ganglion block is an outpatient procedure that takes 20 to 30 minutes total. The patient lays on his or her back, and IV sedation is often used for this procedure since there are some delicate anatomic structures close to the injection region. The patient turns the head away from the side being worked on.

The skin and soft tissue are numbed up, and a needle is placed using fluoroscopy (real time x-ray) over the front of thestellate ganglion region at the bottom of the neck.

Once dye confirms appropriate positioning, then numbing medicine is injected.

If the numbing medicine produces significant pain relief, then additional medication may be injected for longer lasting therapeutic effectiveness. This medication may include phenol (a neurolytic agent), or the pain doctor may also perform a radiofrequency ablation of the sympathetic nerves as well.

HOW WELL DOES A STELLATE GANGLION NERVE BLOCK PROCEDURE WORK?

If your pain is coming from a sympathetic nervous system in “overdrive”, the block can work extremely well. In addition, if you have a circulation deficiency such as in Raynaud’s phenomenon, the stellate ganglion blocks may substantially improve those symptoms by increasing circulation (Elias M 2001).

Additional studies have proven the block’s effectiveness for refractory angina, hot flashes and sleep dysfunction in breast cancer, along with shingles pain and PTSD and RSD (Lipov et al).

The length of symptom relief varies considerably between patients, and may be from weeks to years. If the block worked well initially, then it may be repeated as necessary with an expectation of an effective result on subsequent procedures.

WHAT ARE THE RISKS OF A STELLATE GANGLION BLOCK?

Temporary Horner’s syndrome can result from a stellate ganglion block. Notice the drooping eyelid and constricted pupil.

The risks of a stellate ganglion block procedure are typically very low, but may include infection or drug allergic reaction. If the needle is misplaced, there may be a dropped lung (pneumothorax), esophageal perforation, bleeding, or nerve injury.

There may also be some transient weakness due to spread of the anesthetic which could also cause hoarseness or shortness of breath. In addition, there may also be temporary eyelid drooping, pupil constriction, and decreased sweating which usually subsides after the anesthetic wears off.

Arizona Pain Specialists has Award Winning, Double Board Certified pain management doctors who are experts in Stellate Ganglion Blocks. The AZ pain clinics have multiple locations serving Phoenix, Scottsdale, Glendale, Chandler, Mesa, Tempe, Surprise, Ahwatukee, Goodyear, and surrounding areas.