Stellate Ganglion Block in Cincinnati - APSI Wellness
Learn about stellate ganglion blocks for CRPS, upper extremity pain, and sympathetic pain conditions at APSI Wellness in Cincinnati.
Stellate Ganglion Block — A stellate ganglion block targets the sympathetic nerve cluster at the base of the neck to treat pain conditions affecting the head, neck, arm, and upper chest — including CRPS and sympathetically maintained pain.
What Is a Stellate Ganglion Block?
A stellate ganglion block is an interventional pain procedure that involves injecting local anesthetic near the stellate ganglion — a collection of sympathetic nerves located at the base of the neck (C7-T1 level), in front of the vertebral body. These nerves are part of the sympathetic nervous system and influence blood flow, sweating, and pain signaling in the head, neck, arm, and upper chest.
By temporarily blocking these nerves, the procedure can treat pain conditions involving sympathetic nerve dysfunction in the upper body.
How Does It Work?
In certain pain conditions, the sympathetic nervous system becomes overactive and perpetuates a cycle of pain, inflammation, and reduced blood flow. The stellate ganglion block works by:
Temporarily interrupting sympathetic nerve signals to the affected area
Increasing blood flow to the arm and hand
Breaking the cycle of sympathetically maintained pain
Allowing the nervous system to "reset" toward more normal function
A successful block typically produces Horner's syndrome — temporary drooping of the eyelid, constriction of the pupil, and decreased sweating on the treated side — confirming that the sympathetic nerves have been blocked.
Conditions Treated
Complex Regional Pain Syndrome (CRPS) — Types I and II affecting the upper extremity
Sympathetically maintained pain — upper extremity pain driven by the sympathetic nervous system
Phantom limb pain — after upper extremity amputation
Post-herpetic neuralgia — persistent pain after shingles affecting the face, neck, or arm
Raynaud's disease — affecting the hands
Vascular insufficiency — reduced blood flow to the arm or hand
Hyperhidrosis — excessive sweating of the hand
What to Expect During the Procedure
Before: You'll fast for several hours before the procedure. Blood-thinning medications may need to be stopped.
During: You'll lie on your back with your neck slightly extended. Using ultrasound and/or fluoroscopic guidance, the physician identifies the stellate ganglion and places a needle alongside it. After confirming proper position, local anesthetic is injected. The procedure takes 15-20 minutes.
After: Signs of a successful block appear within minutes — warmth in the arm/hand, Horner's syndrome (droopy eyelid, small pupil on the treated side), and nasal congestion on the treated side. These temporary effects resolve in 4-8 hours. You may feel a lump-in-throat sensation or hoarseness temporarily.
Benefits
Can provide dramatic relief for sympathetically maintained pain
Improves blood flow to the affected arm and hand
Diagnostic — confirms sympathetic nerve involvement
May break the pain cycle in CRPS when performed early
Can be repeated in a series for cumulative benefit
Quick, minimally invasive procedure
Risks and Side Effects
Horner's syndrome (temporary, expected sign of successful block)
Hoarseness or difficulty swallowing (temporary, from anesthetic spread to nearby nerves)
Injection site soreness
Temporary arm heaviness
Rare: pneumothorax, recurrent laryngeal nerve block, vascular injection, seizure
Very rare: epidural or spinal injection
Frequently Asked Questions
Is the droopy eyelid permanent?
No. Horner's syndrome (droopy eyelid, small pupil) is a temporary and expected sign of a successful stellate ganglion block. It resolves as the local anesthetic wears off, typically within 4-8 hours.
How many blocks will I need?
A series of 3-6 blocks is common, typically performed 1-2 weeks apart. Early and aggressive treatment of CRPS with a series of blocks can lead to longer-lasting improvement.
Will my voice be affected?
Temporary hoarseness may occur if the local anesthetic spreads to the recurrent laryngeal nerve. This is self-limiting and resolves within hours. Avoid eating or drinking until hoarseness resolves to prevent aspiration.
Can stellate ganglion blocks help with PTSD?
There is growing research interest in stellate ganglion blocks for PTSD, with some promising results. However, this is considered an off-label use. Discuss with your physician if you're interested.
What if the block doesn't help my arm pain?
If the block provides no relief despite confirmed sympathetic blockade (Horner's syndrome), your pain may not be sympathetically maintained. Your physician will explore alternative diagnoses and treatments.
APSI Wellness — Advanced Pain Solutions & Interventions
5405 DuPont Circle Suite A, Milford, OH 45150 | Phone: (513) 936-3050
https://apsiwellness.com/services/stellate-ganglion-block