Discover how stellate ganglion blocks may help manage chronic pain, PTSD, anxiety, and menopausal hot flushes by regulating autonomic nerve activity.
Summary
A stellate ganglion block is not only useful for treating chronic pain. Recent studies show that it may also help regulate the autonomic nervous system to improve post-traumatic stress disorder (PTSD), anxiety, and menopausal hot flushes.
The Stellate Ganglion: A Two-Way Bridge Between Emotions and the Body
The stellate ganglion is part of the autonomic nervous system, located in the lower neck near the junction of the chest. It acts primarily as a relay station for sympathetic nerve signals, transmitting outputs to the head, neck, face, upper limbs, and heart. It is also involved in sending sensory information back to the brain. Because of this, the stellate ganglion can be viewed as a crucial connection point between the body’s physical state and the brain’s emotional networks.
Traditional Uses: Tackling Stubborn Chronic Pain
A stellate ganglion block (SGB) has long been widely used to treat chroinc pain in the head, face, and upper limbs. Doctors temporarily block sympathetic nerve transmission by injecting a local anaesthetic. This procedure is used to treat conditions such as complex regional pain syndrome (CRPS), post-herpetic neuralgia (nerve pain following shingles), migraines, and certain disorders related to blood vessel spasms or an overactive sympathetic nervous system.
Medical Breakthroughs: Resetting the Emotional ‘Switch’?
In recent years, the medical community has begun to re-examine the relationship between the stellate ganglion and emotional regulation. According to two double-blind randomised controlled trials conducted in 2016 and 2020, a stellate ganglion block can effectively alleviate symptoms of post-traumatic stress disorder (PTSD) while simultaneously improving anxiety, depression, and pain-related issues [1][2].
Subsequent systematic reviews and meta-analyses have also supported this therapeutic approach [3].
Furthermore, a 2023 small clinical study showed that a stellate ganglion block can reduce anxiety symptoms, with the positive effects lasting for a month or longer [4].
Beyond its emotional applications, the procedure may also improve menopausal symptoms such as hot flushes [5].
The Science Behind It: Why Are the Effects So Long-Lasting?
How a local anaesthetic that remains in the body for only a few hours can bring about improvements lasting weeks or even months is not yet completely understood.
In 2009, Lipov proposed a hypothesis suggesting that chronic stress may be accompanied by an abnormal increase in nerve growth factor (NGF) and sympathetic nerve activity, and that a stellate ganglion block could temporarily interrupt this vicious cycle [6].
In 2022, Kim and colleagues offered an alternative explanation. They suggested that the procedure temporarily suppresses overactive sympathetic outputs, making it easier for the parasympathetic nervous system to regain its balance. This, in turn, positively influences the brainstem and emotional regulation networks [7].
This theory helps to explain why a localised nerve block can sometimes produce central brain effects that far outlast the duration of the anaesthetic.
Conclusion: Opening New Directions in Emotional Therapy
In summary, the stellate ganglion block was originally a traditional interventional treatment for pain. However, recent studies demonstrate that it may also hold significant clinical value for addressing emotional trauma, autonomic nervous system imbalances, and menopausal symptoms.
Written by Dr. Lee Yuk-ming, Specialist in Pain Medicine
References:
- Hanling SR, Hickey A, Lesnik I, Hackworth RJ, Stedje-Larsen E, Drastal CA, McLay RN. Stellate ganglion block for the treatment of posttraumatic stress disorder: a randomized, double-blind, controlled trial. Reg Anesth Pain Med. 2016 Jul-Aug;41(4):494-500.
- Rae Olmsted KL, Bartoszek M, Mulvaney S, Arroliga M, Diaz A, Anderson E, et al. Effect of stellate ganglion block treatment on posttraumatic stress disorder symptoms: a randomized clinical trial. JAMA Psychiatry. 2020;77(2):130-138. doi:10.1001/jamapsychiatry.2019.3474.
- Gao H, Li Y, Zhou Y, Li Y, Wang Y, Li X. Stellate ganglion blockade for the treatment of post-traumatic stress disorder: a systematic review and meta-analysis. J Psychosom Res. 2025;119:111999.
- Lynch CS, McLay RN, Gantner E, et al. Stellate ganglion block reduces anxiety symptoms by half: a retrospective observational study. J Clin Psychiatry. 2023;84(4):22m14611.
- Freedman RR, Allen-Taylor L, Deegan PC, Babineau DC, Lipov EG. Stellate ganglion block as a treatment for vasomotor symptoms: clinical application. Cleve Clin J Med. 2022;89(3):147-152.
- Lipov EG, Kelty JD, Sanders VL, Turkington TG. A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD). Med Hypotheses. 2009;73(2):267-270.
- Kim SY, Cohen SP, Rodriguez SE, McCabe J, Choi KH. Central effects of stellate ganglion block mediated by the vagus nerve? An alternate hypothesis for treating PTSD. Med Hypotheses. 2022;162:110833.
