What Is a Stellate Ganglion Block?

Medically Reviewed by Neha Pathak, MD on March 17, 2022
4 min read

The stellate ganglion are sympathetic nerves in your neck. They're found on either side of your voice box. You can get an injection called a stellate ganglion block (sympathetic nerve block) to ease pain in your neck, head, upper chest, and upper arm. It can also help with circulation and blood supply to your arm.

The estimated cost of two stellate ganglion block injections is about $2,000. Your insurance may or may not cover it. It usually depends on what you receive the procedure for.

Doctors use stellate ganglion blocks to diagnose or treat nerve injuries or issues with circulation. This includes:

  • Reflex sympathetic dystrophy (long-term pain after an injury, stroke, or heart attack)
  • Causalgia (an intense burning sensation)
  • Complex regional pain syndrome (type I or II)
  • Shingles affecting your head, neck, arm, or upper chest
  • Phantom limb pain

Stellate ganglion blocks may also help in the treatment of certain mental health conditions, like posttraumatic stress disorder (PTSD), anxiety, and depression. Some studies suggest the procedure can help. But others show no link between stellate ganglion blocks and mental illness. Researchers need more data to confirm whether the procedure helps these conditions.

Your doctor might give you an intravenous (IV) medication to calm you down before the procedure. They’ll need to press on your neck to find the right injection spot. This might feel slightly uncomfortable.

You’ll lie down on an X-ray table on your back. Your doctor will clean your neck with antiseptic before they insert a thin needle to inject a local anesthetic near your voice box. This may burn or sting as it goes in.

It’s important that you don’t talk, swallow, or cough during this process. Doing so could cause the needles to move.

Your doctor will use X-ray or ultrasound guidance to insert a second needle. They’ll inject an anesthetic medication. If your pain is in your head, your doctor will keep you lying down on your back. If your symptoms are in your arm, they’ll have you sit up so the medication can move down.

A stellate ganglion block usually takes less than 30 minutes. After the procedure, your care team will have you wait in a recovery room for about 40 minutes to an hour. You’ll be able to go home on the same day as the injection.

After the procedure, some people notice pain relief right away. But your pain could come back a few hours after the local anesthesia wears off.

In other cases, people have reported that their pain stays away even after the local anesthesia wears off. You might not notice symptoms for days or weeks. In these cases, people might not need as much medication. They may also be able to join in on more physical therapy.

Pain relief from a stellate ganglion block is different for everyone. In many cases, you’ll need multiple injections to continue to keep pain away. For you, this might mean only a couple of injections. But for others, it could take 10 or more.

If the procedure works for you, your doctor may suggest you get a series of stellate ganglion blocks every 1-2 weeks.

Usually, your pain-free period will be longer after each round of treatment.

It’s not safe to have a stellate ganglion block if you currently have a fever, cold, infection, the flu, very high blood pressure, or if you’re on blood thinners. Let your doctor know right away if you think these may be concerns for you.

Though serious complications after a stellate ganglion block are uncommon, these risks include infection, bleeding, or nerve damage. Other infrequent complications can include seizures, collapsed lung, or allergic reaction to the medication.

You might have slight bruising or soreness around the area of the injection, though. Other side effects from the procedure could include:

  • Tearing up
  • Bloodshot (red) eyes
  • Droopy eyelids (which could affect your balance)
  • Stuffy nose
  • A hoarse voice
  • The feeling of a lump in your throat
  • A hard time swallowing
  • A tingly or warm feeling in your hand or arm

These usually go away within 4-6 hours.

Once your procedure is over, you’ll want to stay away from any hard activities for 24 hours. It’s best to rest. Don’t drive for the rest of the day. Make sure you have someone available to pick you up.

You can continue your normal schedule the next day.

After a stellate ganglion block, your voice may sound different for a bit. Once it returns to normal, you can start to sip water through a straw. Don’t eat or drink anything for 4 hours after the procedure and until you can safely swallow again. Slowly work your way up to eating solid food.

If you notice severe pain, weakness in your arm, new numbness, a fever of 100.5 or more, or any signs of an infection around your injection, call your doctor right away. These symptoms aren’t normal and could require medical help.

Stellate ganglion blocks might also be able to treat long COVID symptoms. The research on this is new but promising.

Long COVID symptoms include:

  • Fatigue
  • Brain fog
  • Anosmia (loss of smell)
  • Dysgeusia (change in taste)
  • Orthostatic intolerance (unpleasant symptoms that happen after standing up from a lying or sitting position)

Stellate ganglion blocks lead to more blood flow. This can, in turn, ease long COVID symptoms.