Stellate Ganglion Block

By Hudson Mind


The Stellate Ganglion Block is a transformative solution for people living with symptoms of chronic anxiety or Post-Traumatic Stress Disorder (PTSD). The Block was first used in 1926 to relieve chronic pain, but in 2006 psychiatrists and anesthesiologists unlocked new potential when they saw how quickly it relieved the physical symptoms of mental trauma.
This discovery, pioneered by Dr. Eugene Lipov, broke through the barriers of how we recognize and care for mental trauma. Since 2006, Sympathetic Block treatments have consistently delivered rapid alleviation from the physical stress symptoms that have ruled patients’ lives.
Despite their potency, Sympathetic Block treatments still live in the shadows of more conventional care options, like exposure therapy, talk-therapy, and antidepressant medication. And while these treatments are effective for some, they can also present additional challenges, like side-effects and a lengthy duration of treatment, that ultimately leave many cases of PTSD unresolved.
Stellate Ganglion Blocks are here to change that. By targeting the biological repercussions of PTSD, Stellate Ganglion Blocks have helped over 83% of patients break free from the weight of mental trauma.

A Closer Look at Mental Trauma

PTSD is misunderstood. For all its internet buzz, the condition is still chronically underappreciated. Part of the problem lies in defining trauma, or rather, our collective instinct to draw lines around what trauma is and isn’t.
PTSD entered the psychological lexicon in 1980, after psychologists began correlating symptoms among Vietnam veterans. The notion of PTSD as a product of combat (and only combat) quickly took hold.
Today, the condition is still largely associated with war. And while an alarming number of veterans do live with PTSD, the real boundaries of trauma—and what causes it—are significantly broader and more complex.
In 1980 researchers relegated trauma as, “an extraordinary event outside the range of human experience,”— the unimaginable. Today the CDC defines trauma as an experience “marked by a sense of horror, helplessness, serious injury or the threat of serious injury or death.”
Clinical perception has evolved over the past 40 years, but public perception of trauma is still playing catch-up. Research into the experience of trauma is still unfolding, but here are a few examples of what we know so far:  
  • Prior to the COVID-19 pandemic, 1 in 11 adults struggled with PTSD at some point in their lives.
  • Between 30%-40% of direct victims of natural disasters experience PTSD.
  • PTSD is not always an immediate response—some don’t feel symptoms until years after a traumatic experience.
The ongoing exploration into the enduring and invisible injury of trauma is vital. The more people can understand just how expansive trauma is, the more likely they will be to recognize symptoms in themselves and seek assistance.

The body's Response to Trauma

Trauma lives in people’s bodies—and in some cases, it can hold a body hostage for years.
During a traumatic or threatening experience, the body automatically kicks into its fight-or-flight response as a means of survival. As soon as danger is perceived, the brain sends a SOS to the nervous system, triggering a burst of neuroendocrine signals that can be life-saving. When danger dissipates, the sympathetic nervous system is meant to retreat down to neutral levels, but sometimes it remains in a fight-or-flight state of alarm and alters the body’s biological condition.
The system remaining in sympathetic overdrive can activate nerve growth that hinders the brain’s ability to decipher danger, perpetuating an environment of constant fear and stress.
This state of constant internal stress can manifest in many ways, including:
  • Disrupted sleep
  • Overwhelming panic
  • Fits of unprovoked anger
  • Difficulty concentrating
  • Hypervigilance
  • Overly sensitive startle response
These persistent, physical responses to a traumatic event can make daily life difficult, and in some cases, unmanageable.

Resetting the Nervous System with a Stellate Ganglion Block

Anesthesiologists and clinical researchers have found that one way to bring the nervous system back down from a heightened state is by administering anesthesia to a bundle of nerves called the Stellate Ganglion. This nerve cluster sits just above the collarbone and directly coordinates the nervous system’s fight-or-flight response.
Temporarily numbing the Stellate Ganglion gives the body’s sympathetic nervous system the chance to rest and reset at a more neutral level. This temporary respite can rapidly diminish the feelings of heightened anxiety and panic that linger in the bodies of people who have experienced mental trauma.
During a 20-minute procedure, a board-certified anesthesiologist uses advanced ultrasound technology to precisely administer a local anesthetic into nerve bundles in the neck. Once admitted, the anesthetic temporarily shuts off the nerve bundle, keeping it from sending more distress signals. Our physicians may also utilize Pulsed Radiofrequency Ablations or other medications to further extend the effects of the block.
These blocks not only stop future nerve growth in the brain, but they also eliminate extra nerve fibers that may have already been created while the sympathetic nervous system was locked in fight-or-flight mode.

Stellate Ganglion Block for Anxiety

Stellate Ganglion Blocks are not just adept at reducing the effects of PTSD, they also show promising results for mitigating chronic anxiety.
Anxiety is increasingly prevalent in modern life; research suggests that since the onset of the COVID-19 pandemic, global anxiety rates have risen from 7.3% to 25%.
Anxiety manifests in the body in numerous ways. And if common therapeutic approaches like talk-therapy, cognitive behavioral therapy, or SSRI medications do not provide relief, these symptoms can make managing relationships and daily life a constant battle.
Common symptoms of anxiety include:
  • Fear of losing control
  • Fear of physical injury
  • Increased heart rate
  • Nervousness
  • Nausea
Stellate Ganglion Block can reset the nervous systems in patients with anxiety. This neutralizing effect makes it possible for patients to affect lasting behavioral change through talk and cognitive therapy.

Stellate Ganglion Block for Long COVID

The psychological effects of COVID-19 will likely be researched for decades to come. But lasting physiological effects are already evident. More people are being kept from returning to their daily lives due to Long COVID symptoms.
Clinical studies show that 87% of recovered individuals who were previously hospitalized for severe symptoms of COVID-19 experience at least one persisting symptom for over 60 days. Symptoms of Long COVID may include:
  • Difficulty breathing
  • Chronic fatigue
  • Difficulty concentrating
  • Persistent cough
  • Persistent chest pain
  • Joint or muscle pain
  • Insomnia
As of this point in time, many treatments for Long COVID respond directly to the individual’s specific symptoms. However, Stellate Ganglion Block have shown promising results when used to treat a range of Long COVID cases.
Stellate Ganglion Block temporarily reset the body’s sympathetic nervous system, which also restores the balance in communication between the nervous system and immune system. This restored harmony can effectively reduce symptoms of Long COVID.

What to Expect Throughout Stellate Ganglion Block Treatment

Before scheduling any treatment, we will first have you fill out a clinical intake questionnaire which will ask you for information such as your symptoms, medical history and past/current medications. A provider will review this with you in your TeleHealth evaluation, which will be the first step as a new Hudson Mind patient.
Once cleared for treatment, you are ready to schedule! A member of our front desk team will be reaching out to schedule you for your first treatment.
The Treatment
The entire procedure lasts just under 20 minutes. Afterwards, you are welcome to relax and reflect in our recovery lounge.
There are some reactions/side effects that you may experience, such as Horner’s Syndrome. This is something that will be discussed during your evaluation so you will be prepared for what to expect: a drooping of the side of the face/eyes, hoarseness and/or trouble swallowing.
After Treatment
You will receive a follow up from the office to check in on how you’re feeling. We may recommend scheduling a brief check in with your provider to discuss any next steps that may be appropriate in your treatment, whether that’s scheduling an additional injection or discussing other treatments we offer that may work in conjunction with your SGB.

Common Questions

Good question. Here are the facts: In a study of 327 patients who received treatment between December 2016 and February 2020, over 83% reported a 28.9-point decrease in their self-reported PTSD checklist score. These patients experienced a result that’s almost three times better than that of other treatments measured by the National Center for PTSD Guidance, which considers a 10-point decrease in a PTSD checklist score to be a clinically significant improvement.
Some patients experience alleviation of symptoms immediately, while others may notice relief within 24 hours. Symptom relief lasts anywhere from several months to several years. Though each person has a different response to these blocks, studies demonstrate meaningful improvements up to 3-6 months after the procedure. We encourage you to continue therapy during this period of time.
The Block is administered as an injection, so you will feel it. If it makes you feel more comfortable, you can also request conscious sedation. Any pain really depends on your pain tolerance, but we do everything we can to make you feel as relaxed as possible throughout the experience.
For patients with severe PTSD or anxiety symptoms, or for those who do not experience adequate relief, our physicians may recommend that you come back in for an additional Stellate Ganglion Block.

If you are advised to come in for follow-up, our physicians will inject the block in the sympathetic chain opposite of where you first received treatment. The sympathetic chain on the left side of the body carries different information from the sympathetic chain on the right—some people may respond better to one side versus the other. In a follow-up appointment, we may also use additional techniques like Pulsed Radiofrequency to further extend the relief from the block.
Following your Stellate Ganglion Block, you will experience a temporary eye drooping and redness, congestion, and extra warmth in your face and arm. Don’t worry—these effects are expected and are a positive sign that the block is in the correct place. These side effects typically last for 6-8 hours. Other side effects may include hoarseness and difficulty swallowing. These usually resolve within hours as well. Our team uses two different imaging techniques to ensure accurate placement.
Yes! Stellate Ganglion Block work well in conjunction with other treatments, like talk therapy or many of our other Interventional Mental Health services. You may find that this treatment actually accelerates your progression in therapy, because the reset of your sympathetic nervous system encourages a new sense of calm. In a calm state, you may be able to recall past traumatic events without feeling as though you are reliving and without sparking a fear response. We also offer the Dual Sympathetic Block as part of our Mental BioReboot Program. Please click HERE to learn more.
At this time Stellate Ganglion Block are not covered by insurance for their use in treating symptoms of anxiety, depression, PTSD, or OCD.
You should choose the best healing path for you. Although it is not required, we do recommend working with a talk therapist before and after your Stellate Ganglion Block. The Block can alleviate the symptoms that may be making it difficult for you to talk about an experience without re-living it. We’re happy to share our network of mental health providers and submit a referral on your behalf.
  1. Blum D. A private war: why PTSD is still overlooked. The New York Times. April 4, 2022. Accessed August 1, 2022.
  2. Blum D. The top 4 myths about trauma. The New York Times. May 16, 2022. Accessed August 1, 2022.
  3. Springer, S., Lipov, E. From post-traumatic stress injury to sustained healing: a new model for care. Stella Center. October 7, 2021. Accessed August 1, 2022.
  4. Lynch JH, Mulvaney SW, Kim EH, de Leeuw JB, Schroeder MJ, Kane SF. Effect of Stellate Ganglion Block on Specific Symptom Clusters for Treatment of Post-Traumatic Stress Disorder. Mil Med. 2016;181(9):1135-1141. doi:10.7205/MILMED-D-15-00518
  5. Hudson Mind research: Stellate Ganglion Block—The Science
  1. Alshak, Mark N. and Joe M Das. “Neuroanatomy, Sympathetic Nervous System.” StatPearls, StatPearls Publishing, 26 July 2021.
  2. Goldstein, B. “Anatomy of the peripheral nervous system.” Physical medicine and rehabilitation clinics of North America vol. 12,2 (2001): 207-36.
  3. Chaudhry, A et al. “Detection of the Stellate and Thoracic Sympathetic Chain Ganglia with High-Resolution 3D-CISS MR Imaging.” AJNR. American journal of neuroradiology vol. 39,8 (2018): 1550-1554. doi:10.3174/ajnr.A5698
  4. Kwon, Oh Jin et al. “Morphological Spectra of Adult Human Stellate Ganglia: Implications for Thoracic Sympathetic Denervation.” Anatomical record (Hoboken, N.J. : 2007) vol. 301,7 (2018): 1244-1250. doi:10.1002/ar.23797
  5. Yin, Zhaoyang et al. “Neuroanatomy and clinical analysis of the cervical sympathetic trunk and longus colli.” Journal of biomedical research vol. 29,6 (2015): 501-7. doi:10.7555/JBR.29.20150047
  6. Carter, Jason R, and David S Goldstein. “Sympathoneural and adrenomedullary responses to mental stress.” Comprehensive Physiology vol. 5,1 (2015): 119-46. doi:10.1002/cphy.c140030
  7. Yaribeygi, Habib et al. “The impact of stress on body function: A review.” EXCLI journal vol. 16 1057-1072. 21 Jul. 2017, doi:10.17179/excli2017-480
  8. Fontes, Marco Antônio Peliky et al. “Emotional stress and sympathetic activity: contribution of dorsomedial hypothalamus to cardiac arrhythmias.” Brain research vol. 1554 (2014): 49-58. doi:10.1016/j.brainres.2014.01.043
  9. Lipov, Eugene G et al. “A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD).” Medical hypotheses vol. 72,6 (2009): 657-61. doi:10.1016/j.mehy.2009.01.009
  10. Park, Jeanie et al. “Baroreflex dysfunction and augmented sympathetic nerve responses during mental stress in veterans with post-traumatic stress disorder.” The Journal of physiology vol. 595,14 (2017): 4893-4908. doi:10.1113/JP274269
  11. Wenner, Megan M. “Sympathetic activation in chronic anxiety: not just at the “height” of stress. Editorial Focus on “Relative burst amplitude of muscle sympathetic nerve activity is an indicator of altered sympathetic outflow in chronic anxiety”.” Journal of neurophysiology vol. 120,1 (2018): 7-8. doi:10.1152/jn.00220.2018
  12. Fonkoue, Ida T et al. “Symptom severity impacts sympathetic dysregulation and inflammation in post-traumatic stress disorder (PTSD).” Brain, behavior, and immunity vol. 83 (2020): 260-269. doi:10.1016/j.bbi.2019.10.021
  13. Orr, Scott P et al. “Psychophysiology of post-traumatic stress disorder.” The Psychiatric clinics of North America vol. 25,2 (2002): 271-93. doi:10.1016/s0193-953x(01)00007-7
  14. Sherin, Jonathan E, and Charles B Nemeroff. “Post-traumatic stress disorder: the neurobiological impact of psychological trauma.” Dialogues in clinical neuroscience vol. 13,3 (2011): 263-78. doi:10.31887/DCNS.2011.13.2/jsherin
  15. Miao, Xue-Rong et al. “Posttraumatic stress disorder: from diagnosis to prevention.” Military Medical Research vol. 5,1 32. 28 Sep. 2018, doi:10.1186/s40779-018-0179-0
  16. Kulkarni, Kalpana R et al. “Efficacy of stellate ganglion block with an adjuvant ketamine for peripheral vascular disease of the upper limbs.” Indian journal of anaesthesia vol. 54,6 (2010): 546-51. doi:10.4103/0019-5049.72645
  17. Rajesh, M C et al. “Stellate Ganglion Block as Rescue Therapy in Refractory Ventricular Tachycardia.” Anesthesia, essays and researches vol. 11,1 (2017): 266-267. doi:10.4103/0259-1162.194566
  18. Lipov, Eugene G et al. “Stellate ganglion block improves refractory post-traumatic stress disorder and associated memory dysfunction: a case report and systematic literature review.” Military medicine vol. 178,2 (2013): e260-4. doi:10.7205/MILMED-D-12-00290
  19. Lynch, James H. “Stellate ganglion block treats posttraumatic stress: An example of precision mental health.” Brain and behavior vol. 10,11 (2020): e01807. doi:10.1002/brb3.1807
  20. Summers, Mary R, and Remington L Nevin. “Stellate Ganglion Block in the Treatment of Post-traumatic Stress Disorder: A Review of Historical and Recent Literature.” Pain practice : the official journal of World Institute of Pain vol. 17,4 (2017): 546-553. doi:10.1111/papr.12503
  21. Mulvaney, Sean W et al. “Stellate ganglion block used to treat symptoms associated with combat-related post-traumatic stress disorder: a case series of 166 patients.” Military medicine vol. 179,10 (2014): 1133-40. doi:10.7205/MILMED-D-14-00151
  22. Lynch, James H et al. “Behavioral health clinicians endorse stellate ganglion block as a valuable intervention in the treatment of trauma-related disorders.” Journal of investigative medicine : the official publication of the American Federation for Clinical Research vol. 69,5 (2021): 989-993. doi:10.1136/jim-2020-001693
  23. Lynch, James H et al. “Effect of Stellate Ganglion Block on Specific Symptom Clusters for Treatment of Post-Traumatic Stress Disorder.” Military medicine vol. 181,9 (2016): 1135-41. doi:10.7205/MILMED-D-15-00518
  24. Tian, Ying et al. “Effective Use of Percutaneous Stellate Ganglion Blockade in Patients With Electrical Storm.” Circulation. Arrhythmia and electrophysiology vol. 12,9 (2019): e007118. doi:10.1161/CIRCEP.118.007118
  25. Datta, Rashmi et al. “A study of the efficacy of stellate ganglion blocks in complex regional pain syndromes of the upper body.” Journal of anaesthesiology, clinical pharmacology vol. 33,4 (2017): 534-540. doi:10.4103/joacp.JOACP_326_16
  26. Cha, Yong-Mei et al. “Stellate ganglion block and cardiac sympathetic denervation in patients with inappropriate sinus tachycardia.” Journal of cardiovascular electrophysiology vol. 30,12 (2019): 2920-2928. doi:10.1111/jce.14233
  27. Sahoo, Rajendra K et al. “Stellate ganglion block as rescue therapy in drug-resistant electrical storm.” Annals of cardiac anaesthesia vol. 24,3 (2021): 415-418. doi:10.4103/aca.ACA_168_19
  28. Albazaz, Raneem et al. “Complex regional pain syndrome: a review.” Annals of vascular surgery vol. 22,2 (2008): 297-306. doi:10.1016/j.avsg.2007.10.006
  29. Yucel, Istemi et al. “Complex regional pain syndrome type I: efficacy of stellate ganglion blockade.” Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology vol. 10,4 (2009): 179-83. doi:10.1007/s10195-009-0071-5
  30. Singh Rana, Shiv Pratap et al. “Stellate ganglion pulsed radiofrequency ablation for stretch induced complex regional pain syndrome type II.” Saudi journal of anaesthesia vol. 9,4 (2015): 470-3. doi:10.4103/1658-354X.159480
  31. Datta, Rashmi et al. “A study of the efficacy of stellate ganglion blocks in complex regional pain syndromes of the upper body.” Journal of anaesthesiology, clinical pharmacology vol. 33,4 (2017): 534-540. doi:10.4103/joacp.JOACP_326_16
  32. Makharita, Mohamed Y et al. “Effect of early stellate ganglion blockade for facial pain from acute herpes zoster and incidence of postherpetic neuralgia.” Pain physician vol. 15,6 (2012): 467-74.
    “How SGB Works.”
  33. Stella Center,
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