The stellate ganglion is located on either side of the voice box (at the level of the sixth and seventh cervical vertebrae) and is part of the sympathetic nervous system.
A stellate ganglion block is an injection of medication intended to block sympathetic activity and provide pain relief in the head, neck, upper chest and upper arm. The procedure may also help increase circulation and blood supply to the arm.
Benefits of a Stellate Ganglion Block
A stellate ganglion block may diagnose or treat the following conditions:
- Reflex sympathetic dystrophy
- Complex Regional Pain Syndrome type I or II
- Causalgia
- Herpes zoster infection affecting the neck, head, arm or upper chest
- Phantom limb pain
Side Effects and Risks
The procedure is generally safe, with few temporary side effects such as bruising or soreness at the injection site. More serious and rare complications may include infection, nerve damage and bleeding.
Other temporary side effects of a stellate ganglion block may include:
- Drooping eyelids
- Nasal stuffiness
- Red or “bloodshot” eyes
- Tearing
- Difficulty swallowing
- Hoarse voice
- Feeling of a “lump” in the throat
- Warmth or tingling in the arm or hand
Who is a Candidate?
Patients experiencing nerve pain in the neck, head, upper chest or upper arm and who have not responded to other treatment may benefit from a stellate ganglion block. Patients should speak to their physician to find out if a stellate ganglion block may help alleviate their pain.
What to Expect During a Stellate Ganglion Block Procedure
The patient will be asked to rate their pain on a scale of 0-10. Next, they will lie down on their back on an x-ray table. It’s important that the patient refrains from talking, coughing or swallowing as this can affect needle placement.
The physician will then cleanse the patient’s neck and offer intravenous medication to help the patient relax. Under x-ray or ultrasound guidance, the physician will insert a thin needle into the patient’s voice box and inject a local anesthetic. This will take about 5-10 minutes. A second needle will be inserted, and the anesthetic medication will be injected. It will take about 10-20 minutes for the medicine to take full effect.
Patients will be monitored for about 40-60 minutes. After that, patients will receive verbal and written discharge instructions and will be allowed to go home with their driver.
After the Procedure
Patients will experience immediate temporary pain relief after the anesthetic is injected. Patients will feel long-term pain relief once the steroid takes effect. How long the pain relief lasts will vary. Some patients may experience pain relief for days or weeks. In some cases, only two injections will be necessary, in other cases, patients may need more than 10 injections for long-term pain relief.
Patients should avoid eating, drinking, driving and engaging in rigorous activity for 24 hours after the procedure. Once the patient’s voice returns to normal, they may begin sipping water through a straw and gradually begin eating solid foods.