Our Procedure

A stellate ganglion block (SGB) is a minimally invasive procedure used to diagnose and treat various conditions associated with pain and sympathetic nervous system dysfunction. It involves injecting a local anesthetic medication into the stellate ganglion, a collection of nerves located in the neck. This block can provide relief from pain and other symptoms by interrupting the sympathetic nerve signals to the affected area.

Stellate ganglion blocks are commonly used to manage or alleviate symptoms associated with the following conditions:

1. Complex Regional Pain Syndrome (CRPS): Formerly known as reflex sympathetic dystrophy (RSD), CRPS is a chronic pain condition characterized by intense pain, swelling, and changes in skin color or temperature, usually affecting the arms or legs.

2. Sympathetically Maintained Pain: Certain chronic pain conditions, such as chronic arm or shoulder pain, may be maintained or exacerbated by overactive sympathetic nerves.

3. Vascular Disorders: Conditions like Raynaud's disease, which causes reduced blood flow to the fingers or toes, may benefit from SGB to improve blood circulation.

4. Herpes Zoster (Shingles): SGB can help alleviate the pain associated with shingles, particularly postherpetic neuralgia.

5. Hyperhidrosis (Excessive Sweating): SGB may be used to treat excessive sweating of the face, head, or upper extremities.

Pre-procedure Evaluation: Before the procedure, the patient undergoes a thorough evaluation by a pain management specialist. This may include a review of medical history, physical examination, and possibly imaging studies to identify the source of pain.

Patient Positioning: The patient is typically positioned on their back with a rolled towel or small cushion under the neck to extend the neck and make the injection site more accessible.

Sterilization: The skin over the injection site (usually the front of the neck) is cleaned and sterilized with an antiseptic solution.

Anesthesia: The patient may receive a mild sedative to help them relax, although SGB is often performed under local anesthesia.

Needle Placement: Using fluoroscopy (real-time X-ray guidance) or ultrasound, the physician locates the stellate ganglion on the affected side of the neck. A thin needle is then inserted near the ganglion.

Injection: Once the needle is in the correct position, a mixture of local anesthetic medication, such as lidocaine or bupivacaine, is injected into the area surrounding the ganglion.

Confirmation: The patient may experience temporary warmth or a sensation of fullness in the affected arm or hand, indicating that the medication has reached the intended target.

Post-procedure Observation: After the injection, the patient is monitored for a short time in the recovery area to ensure there are no immediate complications.

Pain Relief: Patients often experience immediate pain relief after the procedure, although it may take a few days for the full effects to be felt.

Activity: Most patients can resume normal activities shortly after the procedure, but strenuous activities should be avoided for a short period.

Follow-up: Patients typically have a follow-up appointment with their physician to evaluate the effectiveness of the block and determine if additional treatments are needed.

Pain Relief: SGB can provide significant pain relief for conditions like CRPS, shingles, and sympathetically maintained pain.

Improved Function: By reducing pain and other symptoms, SGB can improve the patient's ability to perform daily activities.

Minimally Invasive: Compared to surgical interventions, SGB is minimally invasive, with a low risk of complications and a shorter recovery time.

While stellate ganglion blocks are generally safe, they do carry some risks, including:

Bleeding or Infection: As with any injection procedure, there is a risk of bleeding or infection at the injection site.

Nerve Damage: Although rare, there is a risk of injury to nearby nerves or blood vessels during needle placement.

Temporary Side Effects: Patients may experience temporary side effects such as hoarseness, difficulty swallowing, or temporary weakness in the arm on the side of the injection.

Stellate ganglion block is a valuable tool in the management of various pain conditions, offering significant relief for patients with minimal risk. By interrupting sympathetic nerve signals, SGB can alleviate pain, improve function, and enhance the quality of life for individuals suffering from chronic pain conditions. However, it's important for patients to discuss the procedure thoroughly with their doctor to determine if it's the right option for them.