What is a stellate ganglion block?

The stellate ganglion is part of the sympathetic nervous system that is located in your neck, on either side of your voice box. A stellate ganglion block is an injection of medication into these nerves that can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

A stellate ganglion block is used to diagnose or treat circulation problems or nerve injuries, including:

  • Reflex sympathetic dystrophy
  • Causalgia
  • Complex Regional Pain Syndrome type I or II
  • Herpes zoster infection (or “shingles”) affecting the head, neck, arm or upper chest
  • Phantom limb pain

How is a stellate ganglion block done?

First, you may be given an intravenous medication to relax you. Then, you’ll lie on your back on an x-ray table and your neck will be cleansed.

The doctor will insert a thin needle into your neck, near your voice box, and inject a local anesthetic. Then, with x-ray or ultrasound guidance, he or she will insert a second needle and carefully inject an anesthetic medication.

Usually, the procedure takes less than 30 minutes, and you can go home the same day after being monitored in the recovery room.

How effective is a stellate ganglion block?

Some patients report pain relief immediately after the injection, but the pain may return a few hours later as the local anesthetic wears off. Other patients have longer term relief that outlasts the duration of the local anesthetic and helps them to reduce their medication use and increase their participation in physical therapy.

How long the pain relief lasts is different for each patient. Some may be pain-free for days or weeks. Usually people need a series of injections to continue the pain relief. Sometimes it takes only two injections; sometimes it takes more than 10. The relief tends to last longer with each treatment.

What are the risks?

The risk of complications from a stellate ganglion block is very low. However, there could be bruising or soreness at the injection site. Serious complications, including infection, bleeding and nerve damage, are uncommon.

Side effects of the procedure may include:

  • Drooping eyelids
  • Red or “bloodshot” eyes
  • Tearing
  • Nasal stuffiness
  • Hoarse voice
  • Feeling of a “lump” in your throat
  • Difficulty swallowing
  • Warmth or tingling in your arm or hand

These effects will subside within a few hours.

What happens after the procedure?

Do not drive or do any rigorous activity for 24 hours after your stellate ganglion block. Take it easy. You can return to your normal activities the next day.

When your voice returns to normal, you may begin to sip water through a straw and gradually work up to eating solid foods.

Is a stellate ganglion block right for you?

A stellate ganglion block may be right for you if you have nerve pain in the head, neck, upper arm or upper chest that does not respond to other treatment.

Talk to your physician about it. To schedule an evaluation at Cleveland Clinic’s Department of Pain Management call 216.444.PAIN (7246) or 800.392.3353
