What is a Stellate Ganglion Block ( SGB)

The stellate ganglion is a bundle of sympathetic nerves located in the lower neck. These nerves help regulate blood flow, temperature, and nerve activity to the face, neck, chest, and upper extremity. When these nerves become overactive—as seen in conditions such as Complex Regional Pain Syndrome (CRPS) or other types of sympathetic-mediated pain—they can cause significant burning pain, swelling, temperature changes, color changes, and hypersensitivity.

A stellate ganglion block (SGB) is a minimally invasive injection used to temporarily interrupt this abnormal nerve activity and reduce pain.

Goal of the Procedure

The purpose of a stellate ganglion block is to:

  • Reduce pain associated with CRPS or sympathetically maintained pain
  • Improve blood flow and reduce swelling
  • Help restore the temperature and color changes of the affected limb
  • Decrease hypersensitivity and nerve overactivity
  • Support physical therapy and functional improvement
  • Provide diagnostic information (confirm whether the sympathetic nervous system is contributing to the pain)

Some patients experience short-term relief; others may notice longer-lasting improvement after a series of injections.

Procedure Overview

  • You are brought into a sterile procedure suite and positioned lying on your back with your head slightly extended.
  • The skin on the side of the neck being treated is cleansed with antiseptic solution.
  • Using ultrasound or fluoroscopic (X-ray) guidance, your provider carefully identifies the stellate ganglion region.
  • A small amount of local anesthetic is used to numb the skin.
  • A thin needle is guided to the targeted area near the sympathetic nerve bundle.
  • A small amount of local anesthetic, and in some cases steroid, is injected.
  • The injection takes just a few seconds, but your provider monitors you closely for several minutes afterward.
  • You will then move to the recovery area for observation before being discharged home.

After the Procedure

Follow the instructions provided at discharge:

  • A warm feeling in the face or arm, temporary drooping eyelid, nasal congestion, or redness of the eye is normal. This indicates the block is working.
  • Avoid driving or operating machinery for the rest of the day.
  • Mild soreness at the injection site can occur for 24–48 hours.
  • Ice packs and gentle stretching of the upper extremity may help relieve discomfort.
  • You may resume normal activities the next day as tolerated.
  • The care team will contact you to assess symptom relief and discuss next steps or additional treatments.

Expected Results

  • Temporary warmth, flushing, or heaviness in the treated arm typically appears within minutes.
  • Pain relief may be immediate or may develop gradually over several hours.
  • Several injections may be needed for sustained benefit, depending on the diagnosis and response.
  • Many patients experience improved tolerance to physical therapy and increased function following the block.

If Your Procedure Includes Sedation

(Varies by patient; sedation is not always required.)

  • No solid food for 8 hours before the procedure.
  • Clear liquids allowed up to 2 hours prior (water, clear juices without pulp, broth, tea, black coffee).
  • No carbonated beverages, gum, candy, or mints for 2 hours before your appointment.
  • The care team come on Nhan now what I would do is I would learn on that the rules of basketball OK cause you need that if you don’t know place, you don’t know the basic rules. Are you gonna be good rules of basketball rules of basketball for beginners learn that we’re gonna do that sorry I’m just trying to make that thing go awaywill review your medications in advance to determine which to take the morning of your procedure.

Failure to follow these instructions may result in the need to reschedule.

Potential Risks

Stellate ganglion blocks are generally safe, but as with any medical procedure, there are potential risks:

  • Temporary drooping eyelid, red eye, or hoarse voice (expected and short-term)
  • Soreness or bruising at the injection site
  • Difficulty swallowing (temporary)
  • Infection (rare)
  • Bleeding
  • Intravascular injection (rare due to use of imaging guidance)
  • Nerve injury (very rare)
  • Pneumothorax (collapsed lung — extremely rare)
  • No relief or partial relief of symptoms

Insurance Requirements

Insurance companies may require:

  • Documentation confirming symptoms consistent with CRPS or sympathetic-mediated pain
  • Failure of conservative treatments such as medications, physical therapy, or topical therapies
  • Appropriate imaging or evaluation ruling out other causes of pain
  • Progress notes supporting the need for interventional management