Dual Sympathetic Stellate Ganglion Block Treatments

The stellate ganglion is a bundle of nerves located near the last vertebrae in the neck and is part of the sympathetic nervous system, which governs the “fight, flight, or freeze” response. This nerve cluster plays a critical role in sending signals to the amygdala, the brain's center for processing fear and emotional responses.

In stressful situations, the activation of the sympathetic nervous system prompts the release of cortisol, the body's primary stress hormone. While this response is essential for short-term survival, trauma can cause the stellate ganglion to become hyperactive, leading to the fight-or-flight response being repeatedly triggered long after the traumatic event has passed.

This hyperactivity can result in chronically elevated cortisol levels, which can worsen or perpetuate symptoms of trauma, including depression, anxiety, insomnia, hypervigilance, irritability, and more. For many, these persistent symptoms can significantly disrupt quality of life, creating an ongoing cycle of emotional and physical distress. Stellate Ganglion Block (SGB) offers a way to break this cycle and restore balance to the nervous system.

SGB involves a precise injection of a local anesthetic into the stellate ganglion, a cluster of nerve cell bodies located in the neck. This nerve cluster is part of the sympathetic nervous system, which controls the body's "fight-or-flight" response—regulating heart rate, blood pressure, sweating, and more. By temporarily blocking these nerve signals, SGB helps to calm an overactive sympathetic system and reduce symptoms tied to excessive stress responses.

Here’s a breakdown of how it works:

• Blocking Sympathetic Activity:
  The primary way SGB works is by inhibiting the sympathetic nervous system. This is often confirmed by the development of a temporary condition called Horner’s syndrome, which includes symptoms like a drooping eyelid, a constricted pupil, and reduced sweating on one side of the face. These effects show that the sympathetic nerve supply has been successfully blocked.

• Reducing Stress-Related Proteins:
  Research suggests that SGB may lower levels of nerve growth factor (NGF), a protein linked to stress signaling. High levels of NGF can amplify the stress response and increase pain sensitivity. By reducing NGF, SGB may help regulate stress hormones and calm the nervous system.

• Improving Blood Flow:
  Some studies indicate that SGB can increase blood flow to the brain and other regions, which might support recovery in conditions like Long COVID and traumatic brain injury. This improved circulation could help "reset" the autonomic nervous system and alleviate related symptoms.

• Anti-Inflammatory Effects:
  SGB may also reduce inflammation by decreasing levels of pro-inflammatory cytokines (like IL-6 and IL-1β). This anti-inflammatory action might contribute to its effectiveness in treating chronic pain and other inflammatory conditions.

Before Your SGB Treatment

Your journey begins with a thorough medical intake, where we’ll carefully review your health history, current medications, and specific concerns. This session includes a detailed discussion of the risks, benefits, and alternatives to the Dual Sympathetic Reset (DSR) or SGB treatment. We’ll work together to determine if this approach is the right fit for you and how it can serve as a tool to help process trauma and calm the nervous system.

In addition to the medical consultation, you will also have a separate preparation session with our integration coach. This session is designed to set expectations and strengthen the mind-body connection, helping you enter the experience with clarity and readiness. By addressing both the physiological and emotional aspects of your treatment, we aim to optimize your healing journey.

We recommend arranging for someone to drive you home after the treatment, as the procedure may leave you feeling temporarily light-headed.

During Your SGB Treatment

Your comfort and safety are our top priorities. After checking your vitals, you’ll relax in a comfortable chair in one of our soothing treatment rooms. We’ll insert a small intravenous catheter and administer IV fluids to keep you hydrated.

To begin, we’ll numb the area in your neck with a small needle; most patients describe this as a quick pinch. Once the area is numb, we’ll use live ultrasound guidance to locate the stellate ganglion at the C4 and C6 levels of your neck.

Listening to calming music, you’ll remain awake and alert, able to talk with your doctor as they walk you through each step. Once the stellate ganglion is located, we’ll administer the local anesthetic. With the area numbed, you’ll likely feel only slight pressure at the injection site. The entire procedure takes about 15 minutes, but the visit typically lasts 45 minutes to an hour.

After Your SGB Treatment

Temporary side effects are normal and expected, resolving on their own within 24 hours. The most common side effect is Horner’s syndrome, which is a sign that the SGB is working. Symptoms include:

• A drooping eyelid
• Redness of the eye
• A constricted pupil on the side of the injection
• Nasal Congestion
• Facial flushing/warmth

These effects are harmless and will resolve naturally within hours or by the next day.

Other temporary side effects may include:

• A mild headache, which can be relieved with Tylenol or ibuprofen
• Nausea
• Eye sensitivity, dry eye, or temperature changes on the side of the injection
• Chills
• Body Aches
• Mild soreness in your neck
• A hoarse voice due to the anesthetic temporarily affecting nerves in your voice box (usually resolves in 8–10 hours)
• Temporary numbness in your swallowing muscles, which may make it feel like something is stuck in your throat or make your throat feel dry. Eat and drink cautiously until this subsides.

Planning Your Day

While you don’t need to take the day off work, we encourage you to treat your SGB appointment like a self-care experience—similar to a spa visit. The goal is to help you relax and reset, paving the way for reduced stress and improved well-being.

With preparation, care, and support, this transformative treatment can help you process trauma, calm your nervous system, and open the door to lasting relief.

Research shows that SGB patients experience relief from the physical symptoms of PTSD—such as elevated heart rate and blood pressure, the startle response, and so on—within days of treatment. Months after treatment, many patients reported sustained reduction in irritability and concentration problems. They also reported improvements in their sense of feeling emotionally numb or distant.

Many patients feel ongoing relief from one SGB treatment. One study indicates that two SGB treatments administered a week apart can optimize the benefit. We suggest that patients follow-up with us one week after their first SGB. Based on your response, you and your doctor can decide together if a second SGB is right for you.

SGB has been used for nearly a hundred years as a common treatment for chronic pain. A 1990 study reported that patients with PTSD who were being treated with SGB for chronic pain saw improvement in their PTSD symptoms. This led to several studies to understand SGB’s impact on mental health, as well as the most effective form of administration for trauma healing.

In the 2010s, a team of doctors completed a study with 166 military veterans suffering from PTSD. Three months after their SGB treatments, 70% of the veterans reported significant and ongoing symptom relief. Today, SGB is a routine treatment at VA hospitals that has brought PTSD relief to thousands of veterans. In fact, the VA’s success has led more doctors to offer or recommend SGB to patients suffering from persistent PTSD symptoms.

We are excited to be part of offering this safe and promising therapeutic to more people. At Soft Reboot Wellness, SGB is always administered by a board-certified anesthesiologist, with expert knowledge of the local anesthetics used in SGB. The treatment is completely safe and has helped tens of thousands of patients find meaningful relief from their PTSD symptoms and trauma-associated mood disorders.

Learn More: In 2019, 60 Minutes aired a segment on SGB for PTSD.

At Soft Reboot Wellness, we encourage the use of both SGB and ketamine as complementary tools in your healing journey. Think of it this way: ketamine is like a software reboot for the mind, while SGB acts as a hardware reboot for the body. Together, they help expand your window of tolerance, enabling you to process trauma and emotional challenges more effectively.

To date, nearly all research on SGB for mood disorders has focused on PTSD, with studies showing a high likelihood of meaningful and sustained symptom relief for those diagnosed. Beyond PTSD, we’ve seen SGB bring relief to patients experiencing depression, generalized anxiety, and other conditions. SGB has been associated with:

• Emotional and mental clarity
• Improved memory and concentration
• Reduced insomnia and enhanced sleep quality
• Decreased irritability
• Enhanced sexual function and intimacy
• Reduction in panic attacks and social anxiety
• Improvement in fibromyalgia and POTS symptoms
• Relief from long COVID symptoms, including anosmia, parosmia, and dysgeusia

If you’re curious about whether SGB is right for you, we invite you to discuss your options with our health coach.

Using SGB and Ketamine Together

SGB can be safely used to augment the healing effects of ketamine. Both treatments are tools that work best as part of a comprehensive approach to healing, which may include therapy, lifestyle changes, and other holistic interventions. While ketamine helps reset thought patterns and supports emotional breakthroughs, SGB calms the nervous system, creating the physiological space needed for deeper processing and integration.

Tracking Your Progress

To help you and your care team objectively assess your progress, we use several tools to measure changes in your symptoms and mood. You’ll be asked to log how you feel before and after SGB in the Osmind app, a platform designed to track mental health outcomes. Additionally, we utilize validated assessments such as the PCL-5 (Post-Traumatic Stress Disorder Checklist), PHQ-9 (Patient Health Questionnaire for Depression), and GAD-7 (Generalized Anxiety Disorder Scale) to objectively measure improvements in your symptoms and overall mood.

This comprehensive tracking allows us to fine-tune your treatment plan, monitor your progress, and recommend additional interventions to optimize your healing journey. By combining subjective feedback with objective data, we ensure your care remains personalized and effective.

 

A Holistic Healing Approach

Our goal is to partner closely with you to create a personalized treatment plan that reboots both your mind and body, preparing you for healing on all levels. SGB can provide a meaningful break from trauma and mood disorder symptoms, creating an opening for you to incorporate other essential changes—such as improving your diet, engaging in physical activity, connecting with loved ones, and rediscovering things that bring you joy.

For many patients, SGB and ketamine together represent a powerful step forward on the path to sustained wellbeing and health. Let’s work together to find the approach that works best for you.