What Is A Stellate Ganglion Block?
The stellate ganglion are a collection of cervical nerves located at the sides of the voice box that deliver many sensations, such as pain signals and movement messages, to the brain. When these nerves are injured or otherwise compromised, a stellate ganglion block can help relieve pain, swelling, sweating, poor circulation, and poor mobility in the upper extremities. Once you receive a block, several things may happen:
- Your pain may not be relieved but other symptoms are, which means that the underlying condition is not related to the stellate ganglion (but another block might still be an option)
- Your pain is unrelieved, and you have no other symptom relief (the block is a failure)
- Pain and symptoms resolve (success)
Why Is A Stellate Ganglion Block Performed?
A stellate ganglion block helps with diagnosis and offers relief of pain and other symptoms for a variety of conditions, including:
- Complex regional pain syndrome (CRPS)
- Shoulder/hand syndromes
- Causalgia (nerve injury)
- Phantom limb pain
- Intractable angina
- Shingles (herpetic neuralgia from herpes zoster)
- Poor circulation in the upper extremities
- Raynaud’s phenomenon
- Scleroderma
- Excessive sweating (hyperhidrosis) in the face and upper extremities
- Hot flashes and sleep dysfunction related to hot flashes
- Post-traumatic stress disorder (PTSD)
Some patients experience immediate, relief from their pain and other symptoms, while others find at least partial relief in the days and weeks that follow. If successful, a series of blocks will offer the most relief.
How Is A Stellate Ganglion Block Performed?
First, a local anesthetic will be administered. This may sting initially, and cause some lingering soreness for a few days after the procedure. The doctor will firmly press on your neck to determine the precise placement of the injection – it is imperative that you stay absolutely still, no talking, coughing, or swallowing during the injection. Any movement can result in the needle to be improperly placed. Once the needle is in place, you will be injected with the medication, which may include an anesthetic, a steroid, or both.
What Should I Expect After A Stellate Ganglion Block?
Side effects and complications risks are low. Some patients may experience ‘Horner’s Syndrome’, which is a normal response and usually subsides when the anesthetic wears off (usually with 4 – 6 hours). Symptoms may include drooping of the upper eyelid, pupil constriction, and decreased sweating. Other rare side effects and risks include red eyes, feeling like you have a ‘lump’ in the throat, difficulty swallowing, misplacement of the needle resulting in bleeding, nerve injury, collapsed lung (pneumothorax), esophageal puncture, hoarseness, shortness of breath, allergic reaction, numbness in the arm on the side of the block, weakness and/or numbness from neck down as long as the life of the injected anesthetic Many of these side effects are short-lived and minor. If you have an active infection, fever, cold, or very high blood pressure, your doctor will not perform a stellate ganglion block until these conditions improve. Talk to your doctor if you are on blood thinners, as this may hinder your ability to receive this block. You will need a friend or family member to drive you on the day of your procedure, as you will not be able to drive home. Plan to relax for the rest of the day of your stellate ganglion block. Recovery is usually fast and easy. You may use ice packs to relieve any minor pain or swelling at the injection site. Do not drink, eat, or attempt to swallow anything for four hours after your procedure. Choose easy-to-swallow foods until your throat feels open and able to properly swallow. Other than avoiding strenuous activity for at least 24 hours after the block, you will be able to return to your normal activities the next day. This procedure is generally safe, but there are a few important issues to watch for. If you experience severe pain, new numbness or weakness in the extremities, temperature of 100.5 or greater or redness, swelling, warmth, or discharge at the injection site, call your doctor immediately. A stellate ganglion block is a low-risk, non-surgical treatment. If it was successful the first time, it will usually continue to provide pain relief with repeated treatments.