What is a Stellate Ganglion Block?

A Stellate Ganglion Block is a specialised injection used to relieve pain or symptoms in the face, neck, upper chest, or upper limb that are associated with overactivity of the
sympathetic nervous system. The stellate ganglion is a collection of nerves located in the lower neck. Injecting local anaesthetic near this structure temporarily blocks these nerves, helping to reduce pain and abnormal nerve signals.

What conditions do we offer this for?

We offer stellate ganglion blocks for patients with:

  • Complex Regional Pain Syndrome (CRPS) of the upper limb
  • Trigeminal neuralgia (selected cases)
  • Whiplash-associated disorder
  • Post-shingles (herpes zoster) pain affecting the face or upper body
  • Post-radiotherapy pain in the head, neck, or chest region
  • Chronic facial or neck pain with suspected sympathetic involvement
  • Hot flushes or menopausal symptoms (in selected cases)
  • Post-traumatic stress disorder (PTSD) or anxiety-related symptoms (in selected settings)
  • Chronic Pain & PTSD

Why is it done?

This procedure is carried out to:

  • Reset the ‘wind-up’ in the pain and the ‘fight or flight system’
  • Reduce pain, burning, or hypersensitivity caused by nerve dysfunction
  • Restore normal blood flow and temperature regulation to affected areas
  • Improve function, sleep, and emotional well-being
  • Provide a diagnostic tool to guide further management
  • Reduce symptoms related to autonomic overactivity, such as sweating, flushing, or temperature sensitivity

What does the procedure involve?

  • You will lie on your back with your neck slightly extended.
  • The skin is cleaned and numbed with a local anaesthetic.
  • Under ultrasound or X-ray guidance, a fine needle is placed near the stellate ganglion (usually at the level of C6 or C7 vertebra).
  • A small amount of local anaesthetic is injected to block the nerve temporarily.
  • The procedure typically takes 15–30 minutes and is done as a day case.

Benefits

  • Switches OFF the pain volume, hoping to reset and reboot with less pain
  • Reduction in pain, tingling, and nerve-related symptoms
  • Improved function and comfort in the face, neck, or upper limb
  • May support recovery in post-shingles or post-radiotherapy pain
  • Can improve sleep, mood, and stress regulation in selected conditions
  • May reduce the need for oral medications

Side Effects

Very Common side effects

(may affect more than 1in 10 patients):
  • Drooping eyelid, red or bloodshot eye, facial warmth (temporary Horner’s syndrome)
  • Hoarseness or mild difficulty swallowing (temporary)
  • Nasal congestion, facial tingling, or a sensation of fullness in the head
  • Pain or bruising at the injection site 

Common side effects

(may affect up to 1in 10 patients):
  • Dizziness or light-headedness
  • Short-term difficulty speaking or voice changes
  • Temporary arm or hand numbness

Uncommon side effects

(may affect up to 1 in 1,00 patients):
  • Infection at the injection site
  • Temporary drop in blood pressure
  • Flushing or sweating on one side of the face

Rare side effects

(may affect up to 1 in 1,000 patients):
  • Nerve injury or prolonged hoarseness
  • Puncture of the lung (pneumothorax)
  • Bleeding or haematoma
  • Allergic reaction to the local anaesthetic

Aftercare Advice

  • You will be monitored after the procedure, and you usually go home the same day.
  • Avoid driving for 24 hours.
  • You may experience temporary symptoms like eyelid drooping, facial warmth, or hoarseness — these are expected and typically resolve within hours.
  • Resume normal activities gradually.
  • A follow-up appointment will be arranged to assess the effect and discuss further options if needed.

Our Clinical Insight

Please attend A&E immediately if you experience:
• Fever, chills, or redness/swelling at the injection site
• Difficulty breathing or chest pain
• Severe hoarseness or difficulty swallowing
• Weakness, numbness, or drooping in the face or arm
• Loss of bladder or bowel control
• Severe or ongoing pain not relieved by your usual medications