Stellate Ganglion Block
The stellate ganglion is a cluster of sympathetic nerve cells located in the neck, at the base of the cervical spine near the collarbone. A stellate ganglion block (SGB) injects local anesthetic adjacent to this ganglion to interrupt sympathetic nerve signaling — producing a range of therapeutic effects for conditions including upper extremity CRPS, vascular pain, and even hot flashes in certain patients.
Conditions Treated
Complex Regional Pain Syndrome (Upper Extremity): Sympathetically maintained pain of the arm and hand is one of the strongest indications for SGB. A series of blocks can provide significant and sometimes lasting reduction in burning pain, allodynia, and swelling.
Raynaud's Phenomenon: Vascular spasm causing discoloration and pain in the hands responds well to sympathetic blockade.
Hot Flashes: Emerging research suggests that stellate ganglion blocks can significantly reduce the frequency and severity of hot flashes in women — including breast cancer survivors who cannot take hormonal therapy. This represents an exciting non-hormonal option.
Hyperhidrosis: Excessive sweating of the head, neck, and upper extremities.
Post-traumatic stress (PTSD) in some patients: Off-label use; emerging evidence base.
The Procedure
Under ultrasound or fluoroscopic guidance, Dr. Rubin places a needle adjacent to the stellate ganglion at the C6 or C7 level of the neck. A small volume of local anesthetic is injected. You may notice Horner's syndrome temporarily — drooping of the eyelid, small pupil, and anhidrosis (decreased sweating) on the injected side — which confirms successful blockade and resolves within hours.
The procedure takes approximately 15–20 minutes. You must have a driver, as you should not turn your head rapidly for several hours.
Safety
Stellate ganglion blocks require significant anatomical expertise given the structures in the neck. Dr. Rubin performs all SGB procedures under real-time imaging guidance to ensure precise placement and maximum safety.
Contact Us
Call 516-492-3100 to discuss whether a stellate ganglion block is appropriate for your condition.