For patients suffering from intractable upper extremity, neck, and facial pain, every day can be an uphill battle. Stellate ganglion blocks are a treatment option that can help level the playing field. Here’s our approach to this potentially life-changing pain treatment at Nevada Pain Care and what you can expect during the procedure.
What are stellate ganglion blocks?
Your sympathetic nervous system is responsible for your “fight, flight, or freeze” stress response and controls heart rate, blood vessel constriction, and blood pressure. The stellate ganglion is a complex of sympathetic nerves located in the cervical (neck) region of your spine.
Located on the front of the vertebrae on either side of your voice box, the stellate ganglion is responsible for pain transmission to areas in your head, neck, and arms.
A stellate ganglion block is an injection of local anesthetic into this area, directly into the stellate ganglion. This block numbs the nerves and prevents them from sending pain signals to the brain. With just one injection, many patients experience profound and long-lasting relief from previously intractable pain syndromes.
Benefits of stellate ganglion blocks
Stellate ganglion blocks can help treat head, neck, chest, or arm pain. Some of the typical causes of upper extremity pain that can benefit from this type of injection include:
- Reflex sympathetic dystrophy
- Complex regional pain syndrome
- Nerve injury
- Herpes zoster (shingles)
- Postherpetic neuralgia
- Angina pain (that does not respond to other treatment)
Research on this treatment have shown:
- Long-lasting and dramatic reduction in pain and increased range of motion for those suffering from complex regional pain syndrome
- Shorter duration of herpes zoster pain and a reduction in the incidence of postherpetic neuralgia after the acute phase
- Improved mortality and reduced or eliminated refractory angina pain
Stellate ganglion blocks may help patients achieve pain relief when more conservative measures have failed.
Other benefits of stellate ganglion blocks
These injections do more than manage pain. For patients with poor circulation due to vascular disease, stellate ganglion blocks may help improve blood flow. Stellate ganglion blocks can also reduce excessive sweating (hyperhidrosis) in the face, head, and neck.
Additionally, this type of block can be used as a diagnostic tool. Patients with a suspected condition can receive this block. If they experience pain relief, it can indicate an accurate diagnosis.
More recently, researchers have found success in treating post-traumatic stress disorder (PTSD) with stellate ganglion blocks. PTSD occurs after trauma that causes an overactive and hypervigilant response from the sympathetic nervous system. People who suffer from PTSD may experience anxiety, insomnia, and other symptoms well after the traumatic event has passed.
When trauma occurs, the levels of norepinephrine increase dramatically, stimulating the fear centers of the brain (the amygdala). This increased norepinephrine and hyperactive fear response may, in fact, cause the growth of more nerves. This process further intensifies and prolongs the PTSD response system. Recovery from PTSD can take years, with many patients continuing to suffer without relief.
Researchers have found that a stellate ganglion block may essentially reset the stellate ganglion and the sympathetic nervous system response. For some, this can relieve the symptoms of PTSD nearly instantaneously. Success rates in treating PTSD with a stellate ganglion block in one study were between 85 and 90%. While researchers and doctors note that recovery from PTSD is best achieved with a comprehensive treatment plan, these promising study results offer hope for those who have suffered for years.
What can I expect during a stellate ganglion block procedure?
Your comfort during this procedure is of paramount importance to our team at Nevada Pain Care. To ensure that, you will likely receive IV anesthetic before the procedure. Some patients may not be comfortable receiving IV anesthetic. In this case, talk to your healthcare team, as it may be possible to use local anesthetic as well.
The stellate ganglion block procedure starts with you lying on your back. A pillow underneath your shoulders allows clear access to the front of your neck.
Once you are comfortable, your doctor uses fluoroscopic (X-ray) guidance to make sure that the needle is properly placed. They will then inject medication (usually lidocaine or bupivacaine) into the stellate ganglion.
The entire procedure takes approximately 30 minutes. If you received IV anesthetic (either full sedation or “twilight” anesthesia), you will be monitored in recovery for a short period of time before you head home for the day.
Note that some health conditions may make you ineligible for this procedure. These include:
- Severe or untreated emphysema
- Patients on anti-coagulation therapy
- Recent myocardial infarction (within a year)
Although this procedure is generally safe, some patients may experience mild side effects. The most common side effect is tenderness or bruising at the injection site, but others include:
- Droopy eyelids
- “Bloodshot” or tearing eyes
- Nasal congestion
- Sensation of a lump in your throat
- Facial numbness
- Difficulty swallowing
- Hoarse voice
These should ease after a few hours. If you experience any signs of infection, like excessive pain, swelling, fever, or a feeling of being unwell, contact your doctor.
Recovery and pain relief
Your doctor will provide specific recovery instructions to you, but in general it’s best to rest for 24 hours after the stellate ganglion block procedure. You can sip water as your throat begins to feel normal. Solid food may be challenging, so stick to nourishing soups and other soft foods for at least four hours after the procedure.
Many will experience pain relief almost immediately but this may be due in part to the anesthetic you receive during the injection and could wear off. For others, pain relief may be instantaneous and long-lasting.
Keeping a pain diary can help you track pain relief. In some cases, an additional injection is necessary to completely relieve your pain. Some patients find near total relief with one injection while others may require a series of injections. Typically patients find that pain relief lasts longer after each injection.
Care you can believe in
This is care you can believe in. Get in touch today to schedule an appointment or to learn more about stellate ganglion blocks.