When your nervous system is stuck in a state of sympathetic hyperactivity (chronic fight-or-flight), it fundamentally alters how you experience daily life. While this response serves a lifesaving purpose in short bursts, a system that never takes a break can cause a wide range of physical, cognitive, and emotional symptoms.

At Meeting Point Health, we utilize a medical procedure known as stellate ganglion block (SGB) to help relieve the nervous system from a state of overdrive. SGB has been performed to treat sympathetically mediated pain conditions since the 1940s.

By applying modern medical research to this decades-old technique, we help patients find relief from a variety of conditions that have often proven resistant to traditional treatments. 

In this article, we will cover:

  • What SGB is and its primary uses
  • The science of how SGB works
  • Who can benefit from the procedure
  • What to expect during and after treatment

What Is a Stellate Ganglion Block?

A stellate ganglion block is a minimally invasive procedure that involves injecting a local anesthetic in and around the stellate ganglion, a cluster of nerves located in the neck. SGBs are a form of peripheral nerve blockade that selectively inhibits sympathetic nervous system activity. 

For many individuals, particularly those navigating the aftermath of trauma, chronic illness, or persistent stress, the nervous system can become hyperactive. SGB temporarily interrupts the flow of stress signals, allowing the body to return to a more balanced, “rest and digest” state.

The Science: How Does the Stellate Ganglion Block Reset Work? 

The stellate ganglion has strong connections to important brain areas like the cerebral cortex, hypothalamus, amygdala, and hippocampus. By performing a stellate ganglion block, the procedure can influence the hypothalamus as a central hub. This helps regulate multiple body systems, including:

  • Autonomic nervous system (fight-or-flight responses)
  • Cardiovascular system (heart rate and blood pressure)
  • Endocrine system (hormone balance)
  • Immune system (reduces inflammation)

Recent research suggests that chronic stress increases levels of nerve growth factor (NGF), which triggers a cascade that raises systemic norepinephrine (adrenaline). This biological loop keeps the brain and body in a state of constant hyperarousal.

  • Interrupting the Cycle: The local anesthetic reduces NGF and sympathetic “sprouting,” effectively lowering norepinephrine levels.
  • Precision Guidance: Using ultrasound-guided technology, Dr. Stephen Matta can visualize the exact placement for SGB. This modern approach significantly increases safety and ensures the anesthetic spreads precisely where it is needed.
  • Rapid Response: Most patients report a sense of calm, clarity, or physical relief within an hour of receiving the injection.

Who is a Candidate for Stellate Ganglion Block?

While stellate ganglion blocks are a powerful tool for treatment-resistant cases, modern clinical practice and research increasingly support their use as a first-line option rather than a last resort. At Meeting Point Health, we’ll do an in-depth evaluation to help determine if this treatment could benefit your unique situation. 

Mental Health & PTSD

SGB has gained significant validation for treating PTSD and severe anxiety. By reducing hyperarousal in the amygdala and other emotional centers, it can alleviate intrusive memories and persistent irritability.

  • Right vs. Left: We typically begin with a right-sided block, as the right hemisphere of the brain is dominant in controlling stress responses and emotional processing. If the initial treatment doesn’t provide the desired outcome, research shows that a follow-up left-sided block can be effective for “non-responders”.

Chronic Illness & “Esoteric” Conditions

Beyond PTSD, SGB is showing promising results in several other challenging areas:

  • Long-COVID & ME/CFS: By improving cerebral blood flow and tempering sympathetic overdrive, SGB can help reduce “brain fog” and the debilitating fatigue associated with Long-COVID and Chronic Fatigue Syndrome.
  • Anosmia: Patients who have lost their sense of smell following viral infections (like COVID-19) have reported a return of function after SGB treatment.
  • Hot Flashes: Especially for breast cancer survivors who cannot use hormone replacement therapy, SGB has been shown to significantly reduce the frequency and severity of moderate to severe hot flashes.
  • Pain & Circulation: SGB is a long-standing tool for managing Complex Regional Pain Syndrome (CRPS), Raynaud’s phenomenon, and phantom limb pain.

What Can I Expect With My SGB Treatment? 

  • How MPH preps patients before injection: A patient receiving SGB will be greeted at our clinic and taken to an individual room. We recommend getting a good night’s rest and hydrating adequately prior to your appointment! 
  • Injection: The injection itself will be led by ultrasound for precision guidance, and most patients describe the feeling as a quick pinch – not painful.  
  • Observation: Side effects are self-resolving after SGB and will be monitored. These may include eye redness, hoarse voice, and warmth or tingling sensations. 
  • Recovery: Rest will generally be recommended the day of SGB due to potential side effects. Most return to normal activity the next day. 

FAQs: 
  1. Is a stellate ganglion block dangerous? SGB is considered a safe procedure, with a low complication rate and most complications being self-limiting. Side effects such as hoarseness, dysphagia, or slight drooping of the eyelid may occur but these generally resolve within hours. 
  2. Is SGB a surgical procedure? No, SGB is not a surgical procedure. It is a minimally invasive outpatient procedure that does not require incisions or general anesthesia.
  3. Is SGB painful? The procedure itself is generally well-tolerated and relatively painless. Patients may experience a brief stinging sensation during the local anesthetic injection, but this discomfort is usually minimal and temporary. Please always discuss your anxieties and concerns with Dr. Matta. There are several options to discuss to ensure a smooth and anxiety free procedure. 
  4. How long does SGB take? The actual SGB procedure usually takes only a few minutes. However, patients should expect to spend additional time on preparation, ultrasound imaging and monitoring. Estimate at least 1-2 hours in the office and be sure you have a ride home.
  5. How long does pain relief from SGB last? The duration of pain relief can vary from person to person and depends on the underlying condition being treated. Some patients experience relief for several weeks to months, while others may need repeat injections for longer-lasting effects.
  6. How many SGB injections are needed for treatment? The number of SGB injections required varies depending on the condition being treated and individual patient responses. Some patients may experience significant relief after a single injection, while others may require 2-4 treatments over time.
  7. Why choose Meeting Point Health in Philadelphia for SGB injections? When considering Stellate Ganglion Block treatment in Philadelphia, you can trust Meeting Point Health for several reasons:
  • Experienced Medical Team: Our team of board-certified physicians and healthcare professionals has extensive experience in performing Stellate Ganglion Blocks. We are dedicated to providing compassionate and patient-centered care.
  • State-of-the-Art Facilities: At Meeting Point Health, we maintain modern and well-equipped facilities that ensure the highest level of patient safety and comfort during the procedure.
  • Comprehensive Care: We offer a holistic approach to patient care, considering not only the physical but also the emotional and psychological aspects of your well-being.
  • Personalized Treatment Plans: Each patient is unique, and we tailor our treatment plans to meet your specific needs and goals, ensuring the best possible outcomes.
  • Post-Treatment Support: Our commitment to your well-being extends beyond the procedure itself. We provide ongoing support and follow-up care to monitor your progress and address any concerns.

Interested to see if Stellate Ganglion Block is right for you?

If you feel stuck in a cycle of stress, pain, or fatigue, you don’t have to navigate it alone. At Meeting Point Health, we are dedicated to helping you reclaim your calm and your quality of life. Talk with one of our patient onboarding specialists today and schedule a consultation with Dr. Stephen Matta to see if a Stellate Ganglion Block is the right first step for your healing journey.

References

  • Deng JJ, Zhang CL, Liu DW, Huang T, Xu J, Liu QY, Zhang YN. Treatment of stellate ganglion block in diseases: Its role and application prospect. World J Clin Cases. 2023 Apr 6;11(10):2160-2167. doi: 10.12998/wjcc.v11.i10.2160. PMID: 37122525; PMCID: PMC10131013.
  • Kirkpatrick K, Khan M H, Deng Y, et al. (February 19, 2023) A Review of Stellate Ganglion Block as an Adjunctive Treatment Modality. Cureus 15(2): e35174. DOI 10.7759/cureus.35174
  • Luo Q, Wen S, Tan X, Yi X, Cao S. Stellate ganglion intervention for chronic pain: A review. Ibrain. 2022 May 28;8(2):210-218. doi: 10.1002/ibra.12047. PMID: 37786891; PMCID: PMC10529017.
  • Mayo Clinic Staff. (2023, August 1). Chronic stress puts your health at risk. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037

Written by Amanda Bates, RN and medically reviewed by Dr. Stephen Matta.