A Stellate Ganglion Block (SGB) is an injection procedure designed to alleviate symptoms associated with Post-Traumatic Stress Disorder (PTSD). It involves delivering a local anesthetic near the stellate ganglion, a collection of nerves located in the neck. This injection temporarily modifies nerve signaling from this bundle, which is thought to reduce the intensity of common PTSD symptoms and offer relief from persistent distress.
The Neurological Basis for SGB in PTSD
The mechanism by which SGB provides relief for PTSD is rooted in the body’s stress response system. PTSD often results in chronic hyperarousal, where the sympathetic nervous system (SNS) becomes persistently overactive. The SNS initiates the “fight or flight” response, causing symptoms like hypervigilance, anxiety, and insomnia.
The stellate ganglion acts as a crucial relay station for SNS signals traveling to the head, neck, and upper body. Injecting an anesthetic near this nerve cluster temporarily blocks the excessive nerve traffic contributing to sympathetic overdrive. This interruption is hypothesized to allow the overstimulated system to “reset” its activity level.
This “reset” may also involve changes in neurochemistry. Theories suggest a reduction in nerve growth factor and a decrease in brain norepinephrine levels. Norepinephrine is a neurotransmitter linked to alertness and arousal, and its dysregulation is associated with PTSD symptoms.
Factors Determining the Duration of Relief
The duration of relief from a Stellate Ganglion Block for PTSD is highly individualized and varies significantly between patients. SGB is not a permanent cure, but a treatment offering substantial and often long-lasting symptom reduction. Many patients experience relief lasting several months, with some reporting sustained benefits for a year or longer following the procedure.
The local anesthetic wears off within a few hours, so the goal is not long-term pharmacological relief. Instead, the temporary block disrupts the cycle of sympathetic nervous system overactivity, allowing the system to “relearn” a calmer state. The degree of relief is influenced by the initial severity and chronicity of the patient’s PTSD symptoms.
The duration of benefit is also affected by the specific protocol used, such as whether the block was unilateral or bilateral. Other contributing factors include the patient’s overall health, stress levels, and metabolism of the anesthetic agent. For many, the reduction in hyperarousal creates a therapeutic window that makes concurrent psychotherapy more effective.
The Standard Treatment Protocol and Repeat Procedures
SGB for PTSD typically follows a structured protocol, often starting with a unilateral injection on the right side of the neck. This approach is based on evidence suggesting the right stellate ganglion strongly influences stress response circuits. The procedure is performed as an outpatient treatment, taking less than 30 minutes, followed by brief monitoring.
A successful block is confirmed by the temporary appearance of Horner’s Syndrome symptoms, such as a drooping eyelid or constricted pupil on the injection side. This physical confirmation indicates the anesthetic reached the stellate ganglion to interrupt nerve signals. Efficacy is formally measured afterward using standardized tools like the PTSD Checklist for DSM-5 (PCL-5) score.
If symptoms return or the initial response was incomplete, the procedure is repeatable. A second injection is often considered, sometimes on the same side or the contralateral (left) side. Standard treatment often involves two injections administered 10 to 14 days apart to maximize the therapeutic effect.
SGB is safe for repetition, and patients do not develop resistance to the local anesthetic. While one or two blocks may provide sustained relief, some individuals require subsequent maintenance blocks months or years later if symptoms recur. The frequency of these repeat procedures tends to decrease over time.