Stellate Ganglion Block

A breakthrough treatment for Calming Anxiety and Fear-Based Responses

What are Stellate Ganglion Blocks? (SGBs)

Stellate Ganglion Blocks are precise ultrasound-guided injections that target a collection of nerves in the neck and block impulses that trigger fear-based responses like PTSD (Post-Traumatic Stress conditions), insomnia and anxiety. Symptoms are often relieved in as little as 30 minutes and can last for years. Some of our patients experience immediate relief after the procedure.

Experience Matters

We have been serving the area for pain management and physical therapy for over 30 years. At each visit, we perform a complete “Cervical Sympathetic Blockade” as a standard of care, which means performing the block at the C4 and the C6 level. (Most clinics only treat the stellate ganglion at the C6 level.) This procedure is never done without the use of either ultrasound or fluoroscopic guidance. We typically use ultrasound to create a better visualization of the anatomy and to watch the needle during injections, increasing safety for our patients and providing the most precise and efficient procedure.

 

What Conditions Do They Treat?

  • Anxiety and PTSD (Post-Traumatic Stress conditions)

  • Work-related stress

  • Long COVID symptoms

  • ME/CFS

  • Dysautonomia

  • POTS

  • Parosmia

  • Anosmia

  • Sleep problems and nightmares

  • Postpartum depression

  • Complex regional pain syndrome or reflex sympathetic dystrophy

  • Compartment syndrome

  • Causalgia from nerve injuries

  • Autonomic dysfunction of the upper extremity

  • Herpes zoster infection (or “shingles”) affecting the head, neck, arm or upper chest

  • Phantom limb pain

Who else could benefit from SGB?

C-suite executives facing high stress levels may also benefit from SGB, improving strategic decision-making under pressure. 

How does it work?

Stellate Ganglion Blocks have the ability to “reboot” the nervous system to a pre-trauma state, similar to rebooting a computer. When we inject an anesthetic (using an ultrasound for visual guidance), it blocks the nerve highway that carries information responsible for triggering fear and anxiety-based responses.

At Associated Physicians Group, we use a dual block, or cervical sympathetic blockade, as a more complete block to offer the best evidence-based care for the treatment of post-traumatic stress. That means we treat the upper cervical ganglion as well as the lower cervical ganglion during each session.

We often encourage patients to use this treatment as part of a full program with a behavioral health care specialist. Stellate Ganglion Blocks are effective at creating an immediate reduction in symptoms and a lasting calm that opens up a window of opportunity where other treatments, including behavioral therapies, can provide complete healing.

Why Choose APG for SGB Treatments?

First, we’ve been serving the needs of the Metro East area for over 30 years, and we have 4 offices: O’Fallon, Swansea, Edwardsville & Alton. We provide a tailored, personal approach to helping patients, with direct doctor-to-patient consults (in-person and Telehealth available), special expertise in SGB procedures, and recommendations for additional treatments for post-traumatic stress-related injuries. Because of our vast experience in this area, we’ve developed a support network of additional practitioners and other resources for a broader spectrum of care. This “team” approach, combined with the SGB procedure, can be extremely beneficial for post-traumatic-stress injuries.

Frequently Asked Questions

  • We cleanse the skin on your neck on either the right or left side depending on where we are performing the injection. Once sterile, we review the anatomy using ultrasound imaging including a Doppler scan of the blood supply to prepare for the injection. Once we isolate the upper cervical ganglion at C4 and the stellate ganglion at C6, we inject a small amount of anesthetic into the skin to numb the skin. We then slowly inject the anesthetic directly onto the stellate ganglion using a small needle followed with a similar injection at C4.

  • A successful SGB causes a Horner’s syndrome – a group of temporary symptoms “on the side of the injection” that show that the procedure was done correctly. Horner’s syndrome can include drooping of the upper eyelid, constriction of the pupil, appearance of a sunken eye, lack of facial sweating, redness of the white part of the eye, stuffy nose and increased skin temperature on the side of the injection. These symptoms will disappear shortly after the anesthesia wears off. Depending on the type of anesthesia used, it may be roughly 45 minutes to 4 hours before symptoms of a Horner’s response go away.

  • Most patients experience a reduction in anxiety and have a general sense of calm within one hour of the procedure. Occasionally, very few patients experience a delayed response that happens after five days or so.

  • Often people experience other symptoms besides a Horner’s Syndrome following a block. These symptoms do NOT affect the outcome of a good block or mean that you’ve had a good block. They are simply the result of an incidental block to other nerves near the stellate ganglion and occur in as many as 50% to 60% of patients. These symptoms are temporary and can include trouble swallowing, a lump in the throat, or hoarseness, and they go away just like Horner’s syndrome.

  • Our standard treatment involves two injections within 10 to 14 days. The first injection resets the nervous system, and the second injection builds upon the first dose to improve results for most patients. For some conditions like reflex sympathetic dystrophy or complex regional pain syndrome, we perform this procedure weekly for up to six to eight weeks. Some patients also benefit from additional injections several months later.

  • Longer than most people think! It was first used in the U.S. in 1925 to provide relief from chronic pain and then used again for depression in 1945 in The Cleveland Clinic. It was also used to help German prisoners of war recover from their experiences in Russian camps during World War II. However, experts believe it wasn’t used regularly until sometime after 1998.

  • We ensure that no patient leaves our clinic without receiving a proper stellate block, which would mean at least three very noticeable signs of a classic Horner’s Syndrome on the side of the block: a droopy, puffy, or red eye; a smaller pupil; a stuffy nostril; or red/flushed face/neck/or arm. If these symptoms are not present, we will repeat as necessary.

Andrew, a 27 year USAF veteran talks about his experience with the SGB treatment for PTS from APG.

Watch this 60 Minutes Story about the Stellate Ganglion Block as a possible breakthrough treatment.

What are the next Steps?

  1. Talk with our Doctor — Dr. Hamed Sadeghipour is happy to consult with you about the procedure. Fill out the form on the left and a member of our medical team will contact you.

  2. Schedule your consultation or procedure appointment. We offer both in-person and Telehealth consultations.

  3. Schedule your procedure appointment. Fill out the form and we’ll contact you, or simply call our New Patient scheduling department at 888-363-8333 during business hours.

Talk to Beth…

Beth is our Clinical Operations Manager who works directly with Dr. Sadeghipour and has assisted with multiple procedures and is very knowledgable on it. If you’d like to speak to her about the SGB procedure, call her at 618-567-9936. She’s happy to walk you through the process!

Please fill out this form and a member of our staff will contact you within 24 business hours…

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