A stellate ganglion block is a block of the cervical sympathetic chain in the lower neck, performed under ultrasound. It is used where the sympathetic nervous system is driving head, face or upper-limb pain.
What is a stellate ganglion block?
The stellate ganglion is a collection of sympathetic nerve cell bodies at the base of the neck. It sits around the sixth and seventh cervical vertebrae. It supplies sympathetic nerves to the head, neck, and arm. Blocking it interrupts that outflow temporarily.
What does a stellate ganglion block treat?
- Cluster headache and other trigeminal autonomic headaches, where sympathetic involvement is part of the syndrome.
- Complex regional pain syndrome of the upper limb, and other sympathetically maintained pain.
- Persistent facial pain that has not responded to a trigeminal block.
Why is a stellate ganglion block done under ultrasound?
The target sits among the carotid artery, the internal jugular vein, the vertebral artery, the thyroid and the esophagus. A landmark-only technique cannot see any of them. Ultrasound shows the vessels and the soft tissue in real time. It lets the needle be steered around them. That is why it has become the standard approach for this block.
What are the side effects of a stellate ganglion block?
A successful block produces a set of temporary, expected signs on the treated side. They are a drooping eyelid, a smaller pupil, a warm flushed face, nasal congestion and a bloodshot eye. Together these are called Horner’s syndrome. They are not a complication. They are the confirmation that the block worked. They wear off with the anesthetic.
Hoarseness and a lump-in-the-throat sensation are common for a few hours. You should not eat or drink until that has resolved.
Booking online shows our scheduled openings. Call or text for hours that are not listed. Please contact us before coming in rather than arriving unannounced — we need to know what is happening to have the right treatment ready.
A note on coverage, and on timing. Same-day treatment and prior authorization do not run on the same clock. Many insurers take days to weeks to decide. Some acute headache treatments are not covered at all. Your headache will not wait for that process.
We will verify your benefits. Where a treatment needs prior authorization, we will attempt to obtain it. An authorization confirms that a service meets criteria for review — it is not a guarantee of payment. No clinic can make that promise on your insurer’s behalf. Something may be unlikely to be covered, or it may not be certified in time to treat you today. If so, we will tell you before we treat rather than after, so the decision is yours. Payment is due at the time of service.
Frequently asked questions
Can a stellate ganglion block help cluster headache?
Cluster headache and the other trigeminal autonomic headaches are among the reasons we use this block. That is because sympathetic involvement is part of those syndromes. The stellate ganglion supplies sympathetic nerves to the head, neck and arm. Blocking it temporarily interrupts that outflow. The block is placed under ultrasound in the lower neck.
Why does my eyelid droop after a stellate ganglion block?
A drooping eyelid on the treated side, together with a smaller pupil, a warm flushed face, nasal congestion and a bloodshot eye, is called Horner’s syndrome. These signs are not a complication. They are the confirmation that the block worked, and they wear off as the anesthetic does.
What is recovery like after a stellate ganglion block?
Hoarseness and a lump-in-the-throat feeling are common for a few hours afterward. You should not eat or drink until they have resolved. The expected signs on the treated side, such as the drooping eyelid and the flushed face, fade as the anesthetic wears off.
Can a stellate ganglion block help facial pain?
Persistent facial pain that has not responded to a trigeminal nerve block is one of three uses for this block here. The others are cluster headache and complex regional pain syndrome of the upper limb. It fits wherever the sympathetic nervous system is driving head, face or upper-limb pain.