Treatment information
Understanding your pathway
What is the treatment?
A stellate ganglion block places local anaesthetic near sympathetic nerves in the lower neck. It may temporarily alter sympathetic activity affecting the upper limb. It is different from blocking a sensory nerve in the arm and should have a defined clinical purpose rather than be described as a general reset of the nervous system. [1][2]
Who may be considered?
A specialist may consider it for selected upper-limb pain presentations, including some cases of CRPS. Clinical assessment must consider other explanations for the symptoms and the uncertainty of response. A diagnosis of CRPS does not establish that sympathetic activity is the sole cause or that this block will help. [1][2]
Assessment, preparation and consent
Before deciding, discuss your diagnosis, previous treatment, medicines and relevant health conditions. Tell the clinician about allergies, infection, blood-thinning medicines, diabetes and possible pregnancy. Do not stop prescribed medicines yourself. Ask what alternatives are available, including not having a procedure, and allow time to consider the benefits, uncertainty and risks that matter to you. [3]
What happens during treatment?
The clinician uses an appropriate guided technique to place medication near the intended nerve region, with monitoring afterwards. The neck contains important blood vessels, nerves and the airway. Preparation, medication and observation need to reflect those structures and your health, with clear instructions about eating, drinking and transport afterwards. [1][2]
Risks and safety considerations
Temporary eyelid droop, a smaller pupil, hoarseness or swallowing difficulty may occur. Important risks include bleeding, infection, injection into a blood vessel, nerve injury and lung puncture. Breathing difficulty or significant neck swelling requires emergency care. Discuss expected temporary effects and how to distinguish them from concerning symptoms. [1][2]
Recovery and when to seek help
Follow the written instructions for transport, supervision, medicines, activity and driving. Recovery depends on the treatment and your health, so a fixed return-to-work date cannot be promised. Ask who to contact outside clinic hours. Seek urgent assessment for fever with worsening pain, new weakness or other unexpected neurological symptoms. Call 000 for breathing difficulty, collapse or another medical emergency. [4][3]
Expected benefit and limitations
Benefit may be absent or brief. A temperature change or temporary response does not establish a cure or guarantee lasting functional improvement. The result should be interpreted alongside rehabilitation progress. Repeated blocks need a documented rationale, review of adverse effects and consideration of alternatives. [1][2]
Follow-up and rehabilitation
Before treatment, choose a practical goal such as walking, sleep or a daily task. Record changes in that activity, pain and any adverse effects, then discuss them at follow-up. Ask what degree of change would justify further treatment and what would lead to stopping or changing the plan. Rehabilitation and self-management may remain part of care even if symptoms improve. [3][5]
Questions to bring to your appointment
Ask which structure is being targeted, why this approach is being considered and how strong the evidence is for your diagnosis. Clarify costs, the planned review date and any practical help you may need at home. Bring previous reports and your medicine list so the discussion can address your circumstances rather than a generic treatment pathway.
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Stellate ganglion block — Hull University Teaching Hospitals NHS Trust
- Complex regional pain syndrome — NHS
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA
- Dorsal root ganglion / nerve root block / transforaminal injection — Hull University Teaching Hospitals NHS Trust
- Options for chronic pain management — Healthdirect Australia