Sometimes we have pain that doesn't go away even after taking medicine or doing anything. Have you been suffering from pain, especially in the head, neck, upper chest, or arms, for a long time? Perhaps the cause of this is some problem with your nervous system. Today we are going to talk about a special treatment method that doctors use in such cases. This is called Stellate Ganglion Block, or SGB for short.
Simply put, what is Stellate Ganglion Block (SGB)?
Simply put, this is a painkiller injection. But this is not like a regular injection. This injection is injected into a special nerve bundle located in our neck, specifically on either side of our voice box. This nerve bundle is called the 'Stellate Ganglion'.
Think of our nervous system as a network of telephone wires that carry messages. Sometimes, unwanted messages (pain signals) can be sent to certain parts of this network. At such times, what this SGB vaccine does is temporarily "put" that nerve bundle (ganglion) to sleep. It's like turning off a switch. Then the unwanted pain signals from those nerves to the brain stop. This can relieve pain in the head, neck, arms, and upper chest. Also, this treatment helps increase blood flow to the arms.
So, what is this stellate ganglion?
This is a group of nerves located near the first two ribs, just below the collarbone, in the front of our neck. We have one of these on each side of our neck. The word 'stellate' means 'like a star'. So this nerve bundle is named because it resembles the shape of a star.
The sympathetic nervous system is the part of the autonomic nervous system that controls the functions of our body that we don't think about (e.g., heart rate, blood pressure, sweating). So, most of the sympathetic nerve signals to the head, neck, arms, and upper chest come from this stellate ganglion.
Interesting fact: Only 80% of the world's population actually has this stellate ganglion fully formed. In others, the inferior cervical ganglion and the first thoracic ganglion in the neck are not connected. But that doesn't make much difference.
What conditions is SGB treatment used for?
Doctors primarily use this treatment to diagnose and treat long-term pain that originates in the nervous system (sympathetically mediated pain) for which no cause can be found. In addition, this treatment can be used for a variety of other diseases and pain conditions.
| Medical condition | Description |
|---|---|
| Complex Regional Pain Syndrome (CRPS) | Severe, prolonged pain and swelling in an arm or leg after an injury. |
| Phantom Limb Pain | Feeling pain in an arm or leg that was surgically removed. |
| Postherpetic Neuralgia | Nerve pain after chickenpox (herpes zoster). |
| Raynaud's Syndrome | Decreased blood supply to the fingers in response to cold or stress. |
| Excessive sweating (Hyperhidrosis) | Excessive sweating in areas such as the palms and soles of the feet. |
| Other situations | It is also used for cluster headaches, facial pain, chest pain not related to heart disease, and some heart rhythm problems (cardiac arrhythmias). |
Use of SGB for mental health problems
Recently, research has been conducted on the effects of SGB treatment for mental health conditions such as Post-Traumatic Stress Disorder (PTSD). While some people have shown a reduction in PTSD symptoms, others have not. Therefore, this is still in the research stage, and is usually only used "off-label" under the close supervision of a doctor when other treatments have failed.
How is this treatment performed?
Okay, now let's see what happens when this injection is given. There's nothing to worry about, this usually takes less than 30 minutes.
1. Preparation: First, you may be given a small amount of medicine (IV sedation) into a vein in your arm to help you relax. Then, you will be made to lie on your back on a special table.
2. Cleaning: The doctor will thoroughly clean and disinfect the area of the neck where the injection will be given.
3. Numbness: Next, a very fine needle is used to inject a local anesthetic into the affected area of your neck. This will numb you from the pain.
4. Main injection: Then, using advanced technology such as ultrasound or fluoroscopic imaging to precisely locate the nerve root, the doctor inserts a second needle and injects the main pain medication. This technique greatly reduces the risk of injecting the medication in the wrong place.
After the treatment, you will be observed by the medical staff for about an hour. Once everything is confirmed to be fine, you can go home. However, you must have someone to take you home, as you will not be able to drive that day.
How are the results? How long does this last?
This is a problem for everyone. Results vary from person to person. For some people, the pain subsides immediately after the injection, but the pain can return within a few hours after the numbing medication wears off. For others, it can last for weeks or months without pain.
The important thing is that you usually need a series of injections to get the best results. Sometimes you can get results with just two injections, and some people may need more than ten. The good news is that the pain-free time usually increases when you get the injections one after the other.
Are there side effects and risks?
As with any medical treatment, SGB has minor side effects and very rare serious complications.
| Type of disorder | Possible things |
|---|---|
| Common, temporary side effects (go away in a few hours) | |
| The injection site | A bruise or minor pain. |
| Eyes and nose | Drooping eyelids, red eyes, watery eyes, and stuffy nose. |
| Throat and voice | Hoarseness of voice, feeling like something is stuck in the throat, difficulty swallowing. |
| Hand | Feeling of warmth or numbness in the hand. |
| Serious complications that can occur very rarely | |
| Main risks | Infection, bleeding from a damaged blood vessel, nerve damage, lung damage (pneumothorax), Horner's syndrome (a temporary condition). |
The likelihood of these serious complications is very low , because doctors perform this treatment very carefully using technologies such as ultrasound.
When should you see a doctor?
After treatment, if you develop any new symptoms, for example , signs of infection at the injection site (swelling, redness, severe pain, fever) or if difficulty swallowing persists, call your doctor immediately.
SGB is a valuable treatment that can provide relief from long-term pain. However, it does not work for everyone. If you have any concerns or doubts about this treatment, do not hold anything back and talk openly with your doctor. He or she will answer all your questions.
Take-Home Message
- Stellate Ganglion Block (SGB) is a painkilling injection into a special nerve bundle in the neck.
- This provides relief from chronic pain, mainly in the head, neck, arms, and upper chest.
- This is a treatment that can be performed very quickly (less than 30 minutes) and is very safe because it uses technologies such as ultrasound.
- Minor side effects may occur that go away within a few hours, but serious complications are very rare.
- A series of injections may be required for best results.
- Always discuss with your doctor whether this treatment is right for you and what its pros and cons are.
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