What is SGB and How Does it Work?

A Stellate Ganglion Block (SGB) is a safe outpatient procedure that involves the injection of a local anesthetic into the stellate ganglion, a collection of nerves located in the neck. This procedure is guided by ultrasound to ensure precision and safety. By temporarily blocking the sympathetic nervous system, SGB helps to calm the fight-or-flight response, which can be overactive in individuals dealing with trauma or chronic stress.

The effects of SGB can be profound. Many patients experience reduced cortisol levels, decreased inflammation, and improved regulation of the nervous system. This can lead to significant relief from symptoms associated with PTSD, anxiety, chronic pain, and even long COVID.

What to Expect Before Treatment

Before your SGB injection, you’ll go through a comprehensive intake process. This includes a detailed health history review and a consultation with our clinical team. We want to ensure that you are a good candidate for the procedure and that all your questions are answered.

You will also have a preparation session with one of our integration coaches. This session is designed to help you set expectations and understand the potential outcomes of the treatment. We encourage you to discuss any concerns you may have, as our goal is to make you feel as comfortable and informed as possible.

It’s important to arrange for transportation to and from our facility, as you will not be able to drive yourself home after the procedure.

What to Expect During Treatment

On the day of your SGB injection, you’ll be welcomed into a comfortable treatment room where you will be closely monitored by our experienced medical team. Your vital signs will be taken, and you may receive IV fluids to ensure you are well-hydrated.

Using ultrasound guidance, our anesthesiologist will carefully administer a small injection of local anesthetic at the level of the C4 and C6 vertebrae in your neck. The procedure typically lasts about 15 minutes, and you will remain awake and calm throughout the entire process. Many patients find the experience to be relaxing, and we offer calming music to enhance your comfort.

What to Expect After Treatment

After your SGB injection, you may experience some mild, temporary side effects. These can include a drooping eyelid, dry throat, or slight hoarseness. Don’t worry—these effects are usually short-lived and resolve within 24 hours. You can return to work the following day, but remember that you will need someone to drive you home after the procedure.

Many patients find relief after just one session, but for some, a second treatment may enhance the results. We will discuss your progress during your follow-up appointment, which typically occurs one week after your initial treatment.

Complementary Treatments: SGB and Ketamine

At Soft Reboot Wellness, we recognize that emotional healing often requires a multifaceted approach. That’s why we offer SGB in conjunction with ketamine therapy. Think of SGB as a hardware reset for your nervous system, while ketamine acts as a software reboot for your emotional processing. Together, these treatments can support deeper trauma processing and enhance your overall healing journey.

Tracking Your Progress

To ensure that your treatment remains personalized and effective, we utilize tools like Osmind to track both subjective and clinical data. We also employ validated assessment tools such as the PHQ-9, GAD-7, and PCL-5 to monitor your progress. This data-driven approach allows us to make informed decisions about your care and adjust your treatment plan as needed.

A Proven and Safe Treatment

SGB is not a new procedure; it has been used for decades and is backed by a wealth of research demonstrating its safety and efficacy. It is commonly utilized in VA hospitals and has shown promise in treating PTSD and trauma recovery. At Soft Reboot Wellness, we take pride in our dual sympathetic reset approach, creating a personalized plan that blends traditional and integrative medicine to meet your unique needs.

Your Path to Healing Starts Here

If you’re ready to explore the benefits of SGB and see how it can fit into your healing journey, we invite you to schedule a consultation with our team at Soft Reboot Wellness. We’re here to support you every step of the way.

This content is for informational purposes only and is not a substitute for professional medical advice.

What Is a Stellate Ganglion Block (SGB)?

SGB is a safe outpatient procedure that targets a nerve cluster in the neck known as the stellate ganglion. This nerve bundle is part of the sympathetic nervous system and plays a central role in the body’s fight-or-flight response. At Soft Reboot Wellness, we offer a refined version called the Dual Sympathetic Reset (DSR) to optimize relief for conditions like PTSD, anxiety, and long COVID.

How SGB Works to Reset the Nervous System

SGB works by interrupting the chronic stress response that can lead to various mental health issues. Here’s how it functions:

• Blocking Sympathetic Activity: By injecting a local anesthetic near the stellate ganglion under ultrasound guidance, SGB interrupts the chronic stress response.
• Lowering Stress Signals: The block may reduce stress-related proteins like NGF and lower pro-inflammatory cytokines, calming both body and mind.
• Improving Circulation: SGB increases blood flow to the brain, potentially aiding recovery in long COVID and brain injury symptoms.
• Resetting the Brain’s Alarm System: SGB reduces hyperactivity in the amygdala, decreasing cortisol levels and fight-or-flight triggers.

What to Expect Before, During, and After SGB

Understanding the process can help ease any anxiety you may have about the treatment. Here’s what to expect:

Before

A detailed medical intake and a separate preparation session with our integration coach help you enter the procedure with clarity. You’ll need someone to drive you home after the treatment.

During

The treatment lasts about 15 minutes, guided by ultrasound, and is performed by a board-certified anesthesiologist. Most patients describe it as a minor pinch with slight pressure.

After

Mild effects like Horner’s syndrome, hoarseness, or feeling of a lump in the throat may occur and typically resolve within 4 to12 hours. You can resume most activities the next day, but we suggest treating the appointment like a self-care reset.

Is SGB Effective and Safe?

SGB has been used for nearly a century for chronic pain and is now widely studied for trauma-related mood disorders. A landmark study found that 70% of military veterans treated with SGB experienced long-term PTSD relief.

Two treatments one week apart may optimize results, and many patients report sustained emotional clarity, reduced anxiety, and improved sleep. At Soft Reboot Wellness, SGB is always administered by experienced, board-certified physicians using ultrasound guidance and sterile protocols, ensuring your safety and comfort.

Can SGB Be Combined with Ketamine Therapy?

Yes—SGB and ketamine work powerfully together to heal both body and mind. While ketamine reprograms thought patterns and supports emotional processing, SGB calms the physiological stress response to make deeper breakthroughs possible.

Think of SGB as a hardware reset and ketamine as a software reset—each supporting the other in restoring balance. We track your progress using the Osmind app and validated assessments like the PHQ-9, GAD-7, and PCL-5 to tailor your treatment and measure results.

Final Thoughts

At Soft Reboot Wellness, we specialize in advanced SGB protocols to help you overcome trauma and regain emotional stability. Our holistic approach bridges traditional medicine with integrative therapies, all in a tranquil setting in the heart of Silicon Valley. We believe every healing journey deserves compassion, science, and a supportive environment for meaningful transformation.

If you’re ready to explore how SGB therapy can help you, contact us today.

This content is for informational purposes only and is not a substitute for professional medical advice.

We are thrilled to announce that Dr. Sara Herman, MD, ABOIM, founder of Soft Reboot Wellness, was honored to speak at the 2025 ASKP³ Annual Conference, held from January 23 to 25 in Austin, Texas. The American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP³) is a non-profit organization dedicated to the safe and effective clinical use of ketamine for treating mental health disorders and chronic pain conditions. This year’s conference brought together leading experts, researchers, and clinicians in psychedelic medicine, offering a platform to exchange the latest advancements in the field.

A Groundbreaking Presentation on Stellate Ganglion Blocks (SGB) and Ketamine Therapy

Dr. Herman was invited to present on the main stage, where she spoke about the integration of Stellate Ganglion Blocks (SGB) as an adjunct to ketamine therapy for PTSD and autonomic nervous system dysregulation. This advanced treatment approach has been gaining recognition for its potential to reset the nervous system, offering relief for patients experiencing chronic stress responses, hypervigilance, and trauma-related symptoms.

During her presentation, Dr. Herman highlighted the synergy between SGB and ketamine therapy, explaining how the dual approach can significantly improve patient outcomes. The Stellate Ganglion Block, a well-established procedure involving the precise injection of a local anesthetic near the cervical sympathetic ganglia, has been shown to modulate the autonomic nervous system, alleviating conditions such as PTSD, anxiety, and even symptoms related to long COVID, POTS, and perimenopausal vasomotor symptoms.

Her talk was met with enthusiastic praise from attendees, many of whom shared their personal experiences witnessing the profound impact of these treatments. One attendee remarked:

“I have personally witnessed the profound synergy between the Stellate Ganglion Block and Ketamine IV Therapy. Your dual presentation was nothing short of exceptional—I found it immensely enlightening and masterfully delivered!”

Another commented:

“Best talk, hands down!”

Dr. Herman’s Work with Soul Strides Journey Inc.

In addition to her discussion on SGB and ketamine therapy, Dr. Herman also shared insights into her collaborative work with Soul Strides Journey Inc., a 501(c)(3) nonprofit she co-founded with Alison Hunter, LMFT, in 2023. The Soul Strides Journey Method integrates ketamine-assisted therapy, equine-assisted therapy, and group process work, creating a unique and transformative healing experience for individuals navigating trauma, anxiety, and depression.

Soul Strides Journey was designed to provide accessible, deeply integrative healing experiences, leveraging the therapeutic power of horses and the insightful depth of psychedelic-assisted therapy. By incorporating a mind-body approach that includes IFS (Internal Family Systems), ACT (Acceptance and Commitment Therapy), and Jungian principles, the program fosters lasting emotional and psychological transformation.

Dr. Herman’s Expertise in Stellate Ganglion Block Therapy

At Soft Reboot Wellness, Dr. Herman offers the advanced dual injection technique of SGB for clients with PTSD and conditions related to autonomic dysregulation. Unlike traditional approaches, Dr. Herman employs real-time ultrasound guidance, ensuring precision, safety, and optimal results.

SGB has been studied for its ability to “reset” the fight-or-flight response, making it particularly effective for individuals struggling with:

• Post-Traumatic Stress Disorder (PTSD)
• Chronic Anxiety and Panic Disorders
• Long COVID Symptoms
• POTS (Postural Orthostatic Tachycardia Syndrome)
• Perimenopausal Vasomotor Symptoms
• COVID Vaccine Injury
• Insomnia and Sleep Dysregulation

Dr. Herman’s expertise in both SGB and ketamine therapy places Soft Reboot Wellness at the forefront of innovative, integrative mental health and pain management solutions.

Join Us on Your Healing Journey

If you or a loved one is struggling with PTSD, anxiety, depression, or nervous system dysregulation, we invite you to explore the cutting-edge therapies offered at Soft Reboot Wellness. Our team is dedicated to providing compassionate, evidence-based care, helping individuals achieve profound and lasting healing.

📍 Clinic Location:
825 Oak Grove Ave, Suite A101, Menlo Park, CA 94025

📞 Contact Us:
Phone: +1 650-419-3330
Email: hello@softrebootwellness.com

🌐 Learn More:
Visit our website: softrebootwellness.com

We are honored to support you on your journey to wellness.

Understanding Stellate Ganglion Block

What is a Stellate Ganglion Block?

A stellate ganglion block is a procedure where a local anesthetic is injected near the stellate ganglion, a cluster of nerves located in the anterior cervical region of the neck. This cluster of nerves is responsible for regulating various bodily functions, including blood flow, sweating, and sensory perception in the head, neck, chest, and arms. By injecting medication near this nerve bundle, the transmission of neuronal signals can be disrupted, providing relief for conditions such as long Covid, post-traumatic stress disorder (PTSD), and complex regional pain syndrome (CRPS).

During a stellate ganglion block procedure, the patient is typically positioned lying down with their head slightly tilted to the opposite side of the injection site. Using ultrasound guidance, the healthcare provider locates the appropriate location and administers the anesthetic with precision. The effects of the block can be noticed immediately or they can be subtly noticed in a more gradual way over days or weeks.

Benefits of Stellate Ganglion Block

There are several benefits of undergoing a stellate ganglion block. First and foremost, it can provide long-lasting pain relief by interrupting the sympathetic nerve signals that contribute to chronic pain conditions. Many patients who have tried other treatments without success have found significant relief through SGB, allowing them to regain functionality and improve their quality of life.

Additionally, SGB has shown promising results in alleviating symptoms related to PTSD, such as anxiety, hyperarousal, and sleep disturbances, offering a holistic approach to addressing the mental and physical aspects of this condition. The procedure is minimally invasive, usually well-tolerated, and can often be performed on an outpatient basis, minimizing disruption to daily activities.

Risks and Side Effects of Stellate Ganglion Block

As with any medical procedure, there are potential risks and side effects associated with stellate ganglion blocks. While complications are rare, they can include infection at the injection site, bleeding, nerve damage, or allergic reactions to the local anesthesia used. However, these risks are minimized when the procedure is performed by a qualified and experienced provider who follows strict techniques and monitors the patient closely throughout the process.

It is essential for patients to discuss any concerns or medical conditions with their healthcare team before undergoing a stellate ganglion block to ensure the safest and most effective treatment outcome.

Preparing for a Stellate Ganglion Block

Initial Consultation

Prior to undergoing a stellate ganglion block (SGB), you will have an initial consultation with a healthcare provider specializing in pain management or anesthesiology. This consultation serves as a crucial step in the process, allowing the provider to gain a comprehensive understanding of your medical history, current symptoms, and previous treatments.

Through a detailed discussion and physical examination, the provider will assess whether an SGB is the appropriate course of action for your specific condition. Additionally, this consultation provides you with the opportunity to ask any questions or express concerns you may have regarding the procedure.

It is essential to be transparent and forthcoming during this consultation, as accurate information will enable the healthcare provider to make well-informed decisions regarding your pain management plan.

Pre-Procedure Checklist

Prior to the scheduled stellate ganglion block procedure, your healthcare provider will furnish you with a comprehensive pre-procedure checklist. This checklist will outline specific instructions and guidelines to follow in the days leading up to the intervention. These instructions may encompass dietary restrictions, medication adjustments, and other preparatory measures aimed at optimizing the safety and efficacy of the procedure.

Adhering strictly to these guidelines is paramount to ensure that the stellate ganglion block is performed without any complications. Furthermore, it is imperative to promptly notify your healthcare provider of any changes in your health status or medication regimen before the procedure.

By diligently following the pre-procedure checklist and maintaining open communication with your healthcare team, you contribute to creating a conducive environment for a successful stellate ganglion block.

What to Expect During the Procedure

The stellate ganglion block procedure is typically conducted in an outpatient setting. Upon arrival for the procedure, you will be comfortably positioned in a reclining position, and the healthcare team will ensure your comfort and safety throughout the process. The provider will meticulously clean and numb the injection site to minimize discomfort.

Utilizing advanced imaging techniques such as ultrasound guidance, the healthcare provider will precisely locate the appropriate location in the neck region. Subsequently, a local anesthetic medication will be injected into this targeted area, effectively blocking the transmission of pain signals along the nerves.

The entire procedure typically lasts between 15 to 30 minutes, during which you will receive continuous monitoring to ensure your well-being and the procedure’s effectiveness.

Finding a Stellate Ganglion Block Provider Near You

When seeking a stellate ganglion block (SGB) provider in your vicinity, it’s crucial to delve into various aspects beyond mere proximity. Apart from location, consider the provider’s qualifications, such as being board-certified and possessing a wealth of experience in administering SGB. It’s important to inquire about the spectrum of conditions they have effectively treated using SGB.

The process of selecting a suitable SGB provider involves a proactive approach in assessing their compatibility with your needs. Engaging in a preliminary conversation with the potential provider can offer valuable insights and allay any apprehensions.

• How many SGBs have you performed, and what is your level of expertise in this procedure?
• What is your success rate in addressing conditions akin to mine through SGB?
• Could you elucidate the potential risks and side effects associated with the procedure?
• What is the anticipated recovery period post the SGB  procedure?

After the Stellate Ganglion Block Procedure

Post-Procedure Care

Following a SGB, your provider will provide post-procedure care instructions. These instructions may include guidelines on pain management, activity restrictions, and when to follow up with your provider. It’s crucial to follow these instructions to promote healing and optimize the results of the procedure.

After the procedure, you may experience some mild soreness or discomfort at the injection site. This is normal and can typically be managed with over-the-counter pain medications. However, if you experience severe or worsening pain, swelling, or redness at the injection site, it’s important to contact your healthcare provider immediately.

Potential Follow-Up Treatments

In some cases, a single stellate ganglion block may be sufficient to provide long-term relief. However, for others, additional treatments may be necessary. Your provider will discuss potential follow-up treatments based on your individual needs. These may include additional SGB sessions, physical therapy, or other pain management techniques.

In Conclusion

With a clear understanding of what a stellate ganglion block entails and the necessary steps to find a provider near you, you can make an informed decision about pursuing this treatment option. To learn if a stellate ganglion block is the right treatment option for you, contact Soft Reboot Wellness today to schedule a consultation.