The stellate ganglion is a group of nerves in the neck area on either side of the voice box. This group of nerves is part of the sympathetic nervous system.

During a stellate ganglion block, we inject a local anesthetic (pain-relieving medication) and sometimes other medications around this group of nerves to relieve pain and increase circulation. A stellate ganglion block may be performed for people who have the following circulation problems or painful conditions involving the upper extremity or the head and face:

  • Complex regional pain syndrome (CRPS), such as reflex sympathetic dystrophy (RSD) or causalgia

  • Herpes zoster (shingles)

  • Phantom limb pain

  • Excessive sweating

The stellate ganglion block is done to improve function in the upper body areas by reducing pain and swelling.

How you prepare?

The procedure is performed on an outpatient basis, meaning it usually does not require an overnight stay.

You may be asked to avoid eating or drinking anything for a specified time prior to the procedure.

You need to arrange for someone to drive you home after your procedure. Before your procedure, make sure you let us know about:

  • Any prescription or over-the-counter medication you are taking, like: 
    Blood thinners. Consult your pain doctor regarding how long before the procedure to stop blood thinners. You may need to check with the doctor prescribing the blood thinner to make sure it is safe to stop. 
    Diabetes medicines. Consult your doctor regarding any possible dose adjustments you may need if you are not eating prior to the procedure.

  • Any allergic reactions you have ever had to medication or anesthesia.

  • If you are having, or have recently had, symptoms of infection such as fever or chills.

  • If you are pregnant


Our goal is to keep you comfortable and safe for your procedure. An intravenous line may be placed before the procedure to allow administration of intravenous medications, if needed.

Your neck will be cleaned with an antibacterial solution. We then inject a local anesthetic into the skin in this area. You may feel a stinging or burning sensation with the local anesthetic.

After the skin is numb, the stellate block injection is performed. X-ray or ultrasound guidance may be used for the procedure. After the injection, you may start to feel warmth and notice decreased pain.


A stellate ganglion block is a safe procedure. However, it may carry a small risk of the following:

Neck pain
Herniated Discs
Spinal Stenosis

We will discuss possible side effects and complications with you before your procedure.


  • We likely will not recommend a stellate ganglion block if you:

  • Are taking a blood thinner, such as warfarin (Coumadin) or Plavix, and are not able to stop prior to procedure.

  • Have poorly controlled diabetes or heart disease.

  • Have a fever or infection.

  • Are pregnant or may be pregnant. 


Many people may experience some degree of pain relief immediately after a stellate ganglion block. The length of pain relief varies from person to person.

It is not possible to predict the precise results of your stellate ganglion block. If the first injection is helpful, we may recommend a series of injections. When the pain returns, it may be less intense than before the procedure. The duration of pain relief may increase with each injection.

Pain that has started recently tends to respond better than pain that has been present for several years.

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