Overview
The stellate ganglion is a cluster of sympathetic nerves located in the lower part of the neck. These nerves influence pain signalling, blood flow, temperature regulation, and sweating in the upper limb and parts of the face and upper body. When the sympathetic nervous system becomes overactive, symptoms can include burning pain, marked sensitivity, colour or temperature changes in the skin, swelling, and altered sweating.
A stellate ganglion block involves injecting local anaesthetic, sometimes combined with other medication, near this nerve cluster. The aim is to temporarily reduce sympathetic nerve activity, calm pain pathways, and improve circulation related symptoms. It can also help confirm whether the sympathetic nervous system is contributing to symptoms, which may be important when planning longer term care.
Who this treatment helps
A stellate ganglion block may be considered for people with:
• Sympathetic pain affecting the arm, hand, or upper body
• Complex regional pain syndrome in the upper limb in selected cases
• Nerve related pain with prominent sensitivity, burning, or temperature changes
• Circulation related symptoms such as coldness or colour change in the hand
• Pain that worsens with stress, touch, or movement and limits function
• Persistent symptoms despite medication, physiotherapy, or other supportive care
A consultation is required to confirm suitability and to ensure the symptom pattern matches a condition that may respond to sympathetic blockade.
What is a Stellate Ganglion Block
A stellate ganglion block is a minimally invasive injection performed near the stellate ganglion in the neck. The injection typically contains local anaesthetic and may include additional medication depending on your clinical situation. The local anaesthetic aims to temporarily block sympathetic nerve activity, which may reduce pain sensitivity and improve blood flow.
Ultrasound guidance is commonly used to support accurate needle placement and reduce risk. The procedure is usually performed as a day case in a controlled clinical setting by an experienced consultant.
What to expect during the procedure
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Consultant review of symptoms and confirmation of the plan
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Comfortable positioning, usually lying on your back with the neck supported
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Cleaning of the skin and local anaesthetic to numb the area
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Ultrasound guidance to identify key structures and guide needle placement
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Injection of medication near the stellate ganglion
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Monitoring for a short period before discharge
The procedure is typically quick, and you can usually go home the same day.
After the procedure
It is common to experience temporary effects on the treated side, which usually settle within a few hours. These can include:
• Warmth in the arm or hand, sometimes with improved colour
• Mild soreness or bruising at the injection site
• Temporary hoarseness or a feeling of throat fullness
• Drooping eyelid or smaller pupil on the treated side
These effects are expected signs that the sympathetic block has taken effect. Your consultant will advise what to monitor and when to seek advice.
You may be advised to avoid strenuous activity for 24 hours and to keep a brief record of symptoms to help assess the response to treatment.
Benefits
• May reduce sympathetic pain and nerve sensitivity in the upper limb
• May improve circulation related symptoms such as coldness or colour change
• Can support rehabilitation by making movement more comfortable
• Useful as a diagnostic tool to confirm sympathetic involvement
• Minimally invasive and usually performed as a day case
• May reduce reliance on medication in selected patients
Possible risks and side effects
Stellate ganglion blocks are generally safe when performed by experienced clinicians using imaging guidance. Possible risks and side effects may include:
• Temporary soreness or bruising
• Temporary hoarseness or difficulty swallowing
• Dizziness or lightheadedness
• Temporary weakness or numbness in the arm
• Allergic reaction to medication, uncommon
• Infection or bleeding, rare
• Very rarely, irritation of nearby nerves or blood vessels
Your consultant will explain individual risks and how they are minimised.
When to consider other options
If symptoms do not improve, or if the clinical pattern suggests another pathway is involved, your consultant may discuss:
• T2 or T3 sympathetic block
• Other nerve blocks depending on the pain distribution
• Medication optimisation for nerve pain and sensitisation
• A structured rehabilitation plan
• Multidisciplinary pain management for complex cases
Safety note
Please inform your consultant if you take blood thinners, have diabetes, allergies, active infection, are pregnant, or have had previous reactions to local anaesthetic. You may need someone to accompany you home depending on the medications used.
Arrange a consultation to discuss whether a stellate ganglion block is suitable for your symptoms.