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Stellate Ganglion (Sympathetic) Block

The stellate ganglion is a collection of nerves found at the lowest two levels of the cervical section of vertebrae in the neck. The nerves are located in front of the vertebrae and are part of the sympathetic nervous system that supplies the face and arms. These nerves are not involved with feeling or movement, but if a nerve gets irritated by trauma, infection or other causes, the sympathetic activity can cause pain.

A stellate ganglion block (sympathetic block) is an injection of local anesthetic into the front of the neck to numb the stellate ganglion, which can stop the pain. This type of block can also:

  • Diagnose the cause of pain in the face and head, arms and chest.
  • Manage pain in the head, neck, chest or arms caused by nerve injuries, the effects of an attack of shingles, or angina that doesn’t go away.
  • Provide pain relief on one side of the head and neck, the upper arm, and the upper part of the chest on the same side of the body. A stellate ganglion block may be performed to decrease pain and increase the circulation and blood supply to the affected arm.
  • Reduce sweating in the face, head, arms and hands.
  • Treat reflex sympathetic dystrophy, sympathetic maintained pain, or complex regional pain syndrome.

What to Expect

  • We will contact you prior to your appointment to review current medications, your medical history, and potential risks. We will also answer any questions you may have about the procedure.
  • Be sure to tell us if you are pregnant, nursing, or if there is a chance you may be pregnant.
  • Contact your doctor before you stop taking any medication.
  • On the day of your exam, please arrive 15 minutes early to check in.
  • Please arrange to have someone drive you home after the procedure.
  • Although complications are rare, we will review possible side effects and risks with you prior to your exam so you can ask questions and decide if this exam is right for you.

 

  • When you arrive, you will be led to a changing room and given a pair of scrubs to wear for your exam. You will be given a locker to store your clothes, and anything else you may have with you during your exam.
  • This procedure is performed in an Ambulatory Surgery Center (ASC), where you have access to IV sedation and monitoring by a nurse.
  • You will lie on your back with your head tilted slightly back and supported by a pillow.
  • A radiologist with expertise in image-guided injections will apply a local skin anesthetic (numbing medication) near the base of the neck on the affected side.
  • Using X-ray guidance, the radiologist will insert a thin needle and inject contrast solution. The contrast solution will highlight your anatomy to ensure precise targeting of the nerve thought to be causing your pain.
  • The radiologist will then slowly release a combination of anti-inflammatory (steroid) and anesthetic (numbing) medications into the stellate ganglion.
  • You may be asked to wait at the clinic for up to several hours for evaluation and observation.
  • When your procedure is complete, you’ll be escorted back to the changing room so you can change out of the scrubs and back into your clothing.
  • Plan to take it easy for the remainder of the day. You should be able to resume normal activities the next day with some mild soreness in the neck.
  • You may experience increased warmth and redness of the painful arm during and after the injection.
  • You may be asked to keep track of how long pain relief lasts, especially during the first four hours after the block, and report it to your provider. This information is useful when considering next steps.
  • If there is no change in your pain, then your provider can focus on other possible sources of the pain you’re experiencing.
  • If the injection blocked your pain effectively, but only for a short time, your provider may request additional injections or consider a procedure that offers more permanent relief.