The peripheral and sympathetic nervous systems are integral to countless human functions, from voluntary movement to breathing, digestion, and heartbeat. When our peripheral or sympathetic nerves malfunction, our symptoms can range from something innocuous, like changes in sweating and digestion, or poorer circulation, to major, severe, and immediate medical emergencies. One major nerve nexus that can be affected by a variety of health conditions is the stellate ganglion, located on either side of the voice box. stellate ganglion block relief (a nerve block) can provide significant relief from symptoms of postherpetic neuralgia, phantom limb pain, complex regional pain syndrome, and other conditions.
Nerve Blocks in Pain & Disease Management
To understand when and why stellate ganglion block relief might be necessary, it’s important to understand the value of nerve blocks in pain and disease management.
Treatments for neuralgia and neuropathy depend on how our nerves are affected. Systematic problems can cause nerve damage, including autoimmune conditions such as multiple sclerosis, rheumatoid arthritis, lupus, or the effects of long-term elevated blood sugar levels (diabetes) or alcohol poisoning. Direct damage to a nerve can also cause pain, even when the nerve regrows. Genes and lifestyle factors, from diet to environmental exposure, can affect nerve pain and modulate recovery after an injury.
A nerve block may be necessary when other, more conservative pain management measures fail to take effect.
What is a Stellate Ganglion Block?
Ganglions are a collection of nerve cells composed of a special type of nerve cell, called a ganglion cell. Sympathetic ganglions like the stellate ganglion run along either side of the spinal cord, and the stellate ganglion, in particular, merges the ganglion of the neck with that of the upper back and is located around a person’s voice box.
A stellate ganglion block is an injection to the area around the stellate ganglion. The injection is made with an anesthetic medication, which blocks pain signals in the area. These injections are often used to mitigate sympathetically mediated pain symptoms.
Sympathetically mediated pain describes any kind of pain that occurs ostensibly due to a problem with the sympathetic nervous system. In other words, it is sympathetic nerve pain. The primary cause of sympathetic nerve pain in most patients is a complex regional pain syndrome, also known as causalgia or reflex sympathetic dystrophy. This condition and resulting chronic pain are the primary indicators of a stellate ganglion block in the context of pain management.
How Is a Stellate Ganglion Block Performed?
The procedure for a stellate ganglion block is like any other nerve block, and it is entirely non-invasive.
A doctor will begin by injecting local anesthesia into the patient’s neck, before utilizing a longer, specialized needle and x-ray imaging technology to guide the needle to the stellate ganglion.
If needed, a patient may be given medication intravenously to calm them down and keep them calm. Patients are usually awake for this procedure but shouldn’t feel pain.
Once the injection is complete, a patient will be monitored for any signs of an adverse reaction, before being discharged. The procedure itself doesn’t take longer than 30 minutes, and you’ll be back home within the day. Patients are reminded to always report any adverse symptoms or recurring pain as soon as possible.
How Effective Is a Stellate Ganglion Block?
The effectiveness of a stellate ganglion block depends entirely on the nature of the pain being addressed, the dosage and medication used, the patient’s own personal tolerance, and genes.
Some people experience immediate pain relief after the injection. For others, it’s a gradual come down. Sometimes, the pain relief lasts hours, or days. Some patients may be pain-free for weeks. Some patients need multiple injections before the pain stays gone consistently. Sometimes, that means two injections. Sometimes, it means nearly a dozen.
It is almost impossible for a doctor to predict how well a patient will tolerate or respond to a nerve block without a prior medical history with nerve blocks in the same area – and even then, it’s hard to tell what will happen. However, nerve blocks are well tolerated, with few risks.
When Can a Stellate Ganglion Block Be Considered?
Stellate ganglion blocks are currently used primarily to treat sympathetic nerve pain. They may also reduce symptoms from other sympathetic conditions, such as hyperhidrosis and Raynaud syndrome. A stellate ganglion block may also be used as a diagnostic tool – if it reduces a patient’s symptoms, it can help doctors identify their patient’s medical problem. Other conditions that may call for a stellate ganglion block include:
- Peripheral vascular disease
- Upper extremity embolism
- Chronic pain post-surgery
- Cluster headaches
- Scleroderma
- And more.
In cases of more extreme complex regional pain syndrome, a doctor may consider utilizing radiofrequency ablation to cut the stellate ganglion, and reduce symptoms in the long term. Nerve blocks are temporary, and while they may provide lasting relief over multiple injections, they may also fail to act as a long-term solution.
In most cases, a stellate ganglion block is just one modality in a larger treatment plan designed to address a patient’s condition (or multiple co-occurring conditions) in the long term.
Who Shouldn’t Receive a Stellate Ganglion Block?
There are contraindications for a stellate ganglion block or circumstances which bar patients from receiving one. These include:
- Certain types of nerve palsy
- Glaucoma
- Patients on blood thinners (who need to stay on blood thinners)
- Patients with a recent heart attack
- Severe shortness of breath (caused by emphysema)
Are There Any Risks for a Stellate Ganglion Block?
While the risks associated with stellate ganglion blocks are very low, there are potential complications patients must be made aware of. These include most of the complications that can occur after an injection, such as bleeding and infection. More common side effects include bruising or minor tenderness at the injection site. Other short-term side effects can include:
- Difficulty swallowing
- Voice changes
- Leaking tear ducts
- Bloodshot eyes
- Droopy eyelids
Recovery and Long-Term Treatment
Stellate ganglion blocks require very little recovery time, but patients are generally advised not to do anything strenuous or physically demanding for at least 24 hours. So, it isn’t a good idea to hit the gym the morning after. Patients shouldn’t drive themselves home. Come have someone pick you up, or take a cab to the doctor’s office. When you get home, consider eating foods that are easy to swallow, or sticking to soup. Drinking through a straw may also help avoid spills.
In the long-term, a stellate ganglion block relief may wear off in days, or weeks. It may take multiple injections for more long-term pain management goals unless the block was used as a diagnostic tool.
To learn more about Stellate ganglion blocks relief contact PMIR today!
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