A stellate ganglion block is a sympathetic nerve block at the front of the neck, used for nerve pain of the head, neck and arm.
What is a stellate ganglion block?
The stellate ganglion is part of the sympathetic nervous system. Blocking it interrupts sympathetic signaling to the head and arm, which can break the cycle in conditions where that system has become part of the problem.
What is a stellate ganglion block used for?
- Complex regional pain syndrome (RSD) of the arm
- Some post-traumatic head and face pain
- Selected vascular and nerve pain of the upper limb
What happens during a stellate ganglion block?
- You lie on your back with the neck slightly extended, under image guidance.
- Takes about 15 minutes.
- Expect a droopy eyelid, a bloodshot eye, a stuffy nose and a hoarse voice on that side for a few hours — these confirm the block worked and they wear off.
- No sedation is used, so most patients drive themselves home. Do not eat for a short period afterward if the voice is affected.
What are the risks of a stellate ganglion block?
A cluster of expected effects confirms success rather than indicating a problem: a drooping eyelid, a bloodshot eye, a stuffy nose and a hoarse voice on the treated side, all resolving within hours. Hoarseness means the nearby laryngeal nerve is affected, so we ask you not to eat or drink until it has settled to avoid choking. Rare complications include a temporary effect on the nerve supplying the diaphragm, and — very rarely — inadvertent injection into a nearby vessel, which is why the procedure is done under image guidance with careful aspiration.
To discuss whether this is appropriate for you, call us or request an appointment.
How do you know if a stellate ganglion block worked?
Interpretation rests on the block having actually worked, and the visible signs establish that. A limb that becomes warmer confirms sympathetic blockade regardless of what happens to the pain.
Where the block works and the pain returns, that is expected and is the basis for a series. The purpose is to create repeated windows in which the limb can be moved, because restoring use is what changes the trajectory of CRPS.
Before and after your procedure
No sedation. You stay awake under local anesthetic, and most patients drive themselves home. Bring a driver only if an arm feels weak or numb, and only until it wears off. Do not eat or drink until the hoarseness has fully settled, usually a few hours, because the swallowing reflex is temporarily affected. Expect a drooping eyelid, a red eye and a stuffy nose on that side — these confirm the block worked and resolve the same day. Have someone with you at home that evening. Report difficulty breathing immediately.
Frequently asked questions
Is the droopy eyelid a complication?
No — it is the expected sign of a successful block and resolves within hours.
Lumbar Sympathetic Block is the equivalent block for CRPS of the leg.
How many will I need?
CRPS is usually treated with a series, because the aim is to interrupt a cycle and allow rehabilitation, not to provide one afternoon of relief.
This is set out in Complex Regional Pain Syndrome (RSD).
How long does a stellate ganglion block take?
The procedure itself takes about 15 minutes. You lie on your back with your neck slightly extended, and the injection is placed under image guidance at the front of the neck. Plan on a few more hours for the expected effects on that side to wear off. No sedation is used, so most patients drive themselves home.
What are the side effects of a stellate ganglion block?
Expect a droopy eyelid, a bloodshot eye, a stuffy nose and a hoarse voice on the treated side. These are signs the block worked, not problems, and they wear off within hours. A limb that turns warmer is another sign the nerves were blocked. Report any difficulty breathing right away.
Can I eat or drink after a stellate ganglion block?
Not until the hoarseness has fully settled, which usually takes a few hours. A hoarse voice means the nearby nerve to the voice box is affected, and your swallowing reflex is weaker for a while. Waiting avoids choking. Have someone stay with you at home that evening.
Sources
- Tian Y et al. Stellate Ganglion Block Therapy for Complex Regional Pain Syndrome: A Systematic Review and Meta-Analysis. Pain physician, 2024. PubMed 38805523
- Kirkpatrick K et al. A Review of Stellate Ganglion Block as an Adjunctive Treatment Modality. Cureus, 2023. PubMed 36949968
- Tsai EH et al. Stellate ganglion block in perioperative practice: a narrative review. British journal of anaesthesia, 2026. PubMed 41027820
- Fajardo Pérez M et al. Novel ultrasound-guided supraclavicular stellate ganglion block. Pain practice : the official journal of World Institute of Pain, 2024. PubMed 38251786
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