The stellate ganglion is a cluster of nerves in the front of your neck, part of the sympathetic nervous system. That system controls things you do not consciously manage, including blood flow to your head, neck, and arms.
In certain pain conditions, the sympathetic system becomes part of the problem, sustaining pain long after any injury has healed. A stellate ganglion block places local anesthetic near that nerve cluster to interrupt those signals.
What it treats
This block is used for sympathetically mediated pain in the head, neck, chest, and arm. The conditions we most often use it for are complex regional pain syndrome affecting an arm or hand, certain persistent nerve pain conditions in the upper body including facial pain from TMJ disorders and trigeminal neuralgia, circulation problems in the hand and arm, and cancer-related pain affecting these regions.
It is used both to diagnose whether the sympathetic system is driving your pain and, when it is, to treat it.
It is often a series, not a single injection
For conditions like complex regional pain syndrome, one block is rarely the whole treatment. The typical approach is a series, spaced out, with the goal of interrupting the pain cycle long enough for the sympathetic system to reset and for you to make progress in therapy.
Whether that applies to you depends on your response to the first block. Dr. Serpa will not commit you to a series before seeing how you do.
How the procedure works
You lie on your back with your neck slightly extended. The area is cleaned and numbed, and the injection is performed under image guidance, using live X-ray or ultrasound, to place the medication accurately while avoiding nearby structures.
The injection itself takes only a few minutes.
What to expect afterward
A successful block produces temporary and expected effects on the treated side. Your eyelid may droop, your pupil may look smaller, your eye may water, your face may feel warm and flushed, and your voice may sound hoarse. Your hand and arm usually feel warmer.
These are signs the block worked, not complications. They resolve over several hours as the anesthetic wears off.
You should not eat or drink until any hoarseness or difficulty swallowing has fully resolved, and you will need someone to drive you home.