Stellate Ganglion Nerve Blocks for Post-Traumatic Stress Disorder

Stellate Ganglion Nerve Blocks for Post-Traumatic Stress Disorder

If you have experienced a very traumatic event in your life which has resulted in post-traumatic stress disorder or PTSD, then you may be searching for an effective treatment. New studies suggest that a technique known as stellate ganglion nerve blocks could help many PTSD patients, but the research is still not conclusive.

Stellate ganglion nerve blocks involve the injection of a local anesthetic near the stellate ganglion, a nerve cluster found at the base of the neck. A stellate ganglion nerve block may help relieve PTSD symptoms for a few weeks—until the anesthetic wears off—at which time, you may get another injection. At the moment, health experts recommend that stellate ganglion nerve blocks be used in combination with other PTSD therapies.

A Closer Look at Post-Traumatic Stress Disorder

Post-traumatic stress disorder is a common psychological condition affecting about 7 to 8 percent of the U.S. population at some point in their lives. At any given time, about 8 million American adults will be suffering from PTSD, but this is only a small fraction of those who have experienced a traumatic situation.

Although the underlying causes of post-traumatic stress disorder are not known, there are certain factors that elevate the risk of developing this condition:

• Intense or long-lasting trauma
• Previous encounters with trauma, such as abuse as a child
• Professions that may involve traumatic situations like soldier or policeman
• Presence of other mental health issues like anxiety or depression
• Substance abuse issues
• Lack of a social support network
• Family members with mental health problems

The primary symptoms of post-traumatic stress disorder include

• Disturbing thoughts or images of the traumatic event
• Flashbacks or nightmares
• Feelings of sadness, fear or anger
• Avoidance of people or situations that trigger memories
• Disproportionate responses to stimuli like loud noises or incidental touches

Common Therapies for PTSD

If you suspect that you or someone you know is suffering from post-traumatic stress disorder, then strongly consider getting some treatment. Almost 46 percent of patients improve within six weeks of beginning psychotherapy and about 62 percent of people begin improving after taking medications.

There are many kinds of successful PTSD treatment options including

• Cognitive processing therapy—this 12-week program has you working with a therapist to examine how you think about your trauma to develop positive, healing strategies.
• Prolonged exposure therapy—this program consists of 8 to 15 sessions, each lasting about 90 minutes. During these sessions, you and your therapist will identify triggers and develop plans to expose yourself to them in safe, controlled ways until you become desensitized.
• Stress inoculation training—this kind of cognitive behavioral therapy will help you develop coping strategies for stress like breathing techniques.
• Medications—drugs like antidepressants, benzodiazepines, or beta-blockers can reduce fear and anxiety as well as the overstimulated “fight or flight’ response common among PTSD patients

What Is a Stellate Ganglion Nerve Block?

Unfortunately, a large portion of PTSD patients do not respond to conventional therapies, which is why modern medicine is currently searching for more successful treatments. An emerging therapy is stellate ganglion nerve blocks although how and why this technique is effective is not well understood.

The stellate ganglion is a large nerve cluster that includes nerves that travel to the head, neck, and upper extremities. This nerve cluster is a part of the sympathetic nervous system that works in tandem with the parasympathetic nervous system to govern many physiological functions. More specifically, the stellate ganglion controls the “fight or flight” reflex that is closely tied to many PTSD symptoms.

The actual procedure begins with an injection of a sedative to relax you. You will only need a local anesthetic, and you should remain conscious throughout the procedure which should take about 30 minutes to complete.

The doctor will activate the x-ray or ultrasound to help guide the injection needle near the stellate ganglion. Then the doctor will insert the needle and inject the anesthetizing compound near the stellate ganglion. After a short period of monitoring, you should be able to return home.

You may expect some changes in the hours after the procedure including drooping eyelid, bloodshot eye, stuffy eye, and a mild rise in temperature. In a small number of cases, there may be seizures, pneumothorax, numb arm, or nerve damage.

A stellate ganglion nerve block can help a variety of conditions including

• Complex Regional Pain Syndrome Type I or II
• Causalgia
• Reflex sympathetic dystrophy
• Shingles (on the head, neck, arm, or upper chest)
• Phantom limb pain

Stellate ganglion nerve blocks have not yet been approved as a treatment for post-traumatic stress disorder because additional studies need to be conducted confirming its efficacy for this condition. However, stellate ganglion nerve blocks may still be used as an “off label” therapy.

How Effective Is a Stellate Ganglion Nerve Block?

It is difficult to determine the efficacy of stellate ganglion nerve blocks as a therapy for PTSD because the research is ongoing, but there is definitely promise for this technique. In the early 2010s, the U.S. military began offering stellate ganglion nerve blocks as a PTSD treatment at some of its medical facilities.

One study administered by RTI International involved patients from three medical military installations. The study ran from 2064 to 2018 and involved two populations of participants; one received stellate ganglion nerve blocks while the other only received a placebo. A total of 113 PTSD patients—who were active-duty military personnel at the time—were selected for the study, with 108 completing it.

The participants in the non-placebo group received 2 stellate ganglion nerve blocks 2 weeks apart. Symptom severity was measured prior to and 8 weeks after the initial treatment. Results indicate that this therapy did produce significant improvement in PTSD patients.

Given the small size of the study and its limited scope, this one study is hardly conclusive, but it is likely to encourage more research into stellate ganglion nerve blocks as a PTSD therapy as well as more health care providers recommending this treatment to their patients.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA, and you should not post any of your private health information.