Post-traumatic stress disorder (PTSD) can affect many aspects of daily life, including sleep, mood, concentration, and relationships. While many people experience improvement through psychological therapies and medications, some continue to have persistent symptoms despite treatment.
In recent years, Stellate Ganglion Block (SGB) has gained attention as a potential treatment option for some individuals with PTSD. Although originally developed to treat certain pain conditions, researchers are now exploring its potential role in regulating the body’s stress response.
At Monash House Private Hospital, our interventional pain specialists may offer Stellate Ganglion Block for selected patients as part of a broader treatment plan for PTSD.
Understanding the role of the nervous system in PTSD
PTSD involves more than emotional or psychological distress. It is also associated with changes in the body’s autonomic nervous system, particularly the sympathetic nervous system, which controls the body’s “fight-or-flight” response.
In people living with PTSD, this system can become overactive, leaving the body in a constant state of alertness. This may contribute to symptoms such as:
- Hypervigilance
- Anxiety and irritability
- Sleep disturbance
- Difficulty concentrating
- Heightened startle responses
Researchers believe that treatments targeting this overactive stress response may help reduce some PTSD symptoms.
What is a Stellate Ganglion Block?
A Stellate Ganglion Block (SGB) is a medical procedure where a small amount of local anaesthetic is injected near a cluster of nerves in the lower neck known as the stellate ganglion.
These nerves are part of the sympathetic nervous system and influence functions such as blood flow, sweating, and the body’s stress response.
During the procedure, a specialist physician uses imaging guidance, such as ultrasound or X-ray, to precisely place the injection near the stellate ganglion. The anaesthetic temporarily blocks nerve signals travelling through this area.
Stellate Ganglion Block has been used for many years to treat certain chronic pain conditions. Researchers are now investigating whether the same mechanism may help regulate the heightened stress response seen in PTSD.
What does the research say?
SGB is considered an emerging treatment for PTSD, and research in this area is ongoing.
Some clinical studies have reported promising findings. For example, a randomised clinical trial found that two SGB injections given two weeks apart reduced PTSD symptom severity compared with a placebo procedure over eight weeks.
Other studies suggest that SGB may be particularly helpful for symptoms related to hyperarousal, including sleep disturbance and heightened anxiety.
However, results across studies have been mixed, and more large-scale clinical trials are needed to determine how effective the treatment is and which patients may benefit most.
For this reason, many clinicians view SGB as a complementary or adjunct therapy, rather than a replacement for established PTSD treatments such as trauma-focused psychotherapy.
Sources: Randomised clinical trial of SGB for PTSD symptoms (JAMA Psychiatry) and Evidence brief: Effectiveness of stellate ganglion block for PTSD (NCBI)
How the procedure works
At Monash House Private Hospital, Stellate Ganglion Block is typically performed as a short outpatient procedure.
The process usually involves:
- You will lie comfortably on your back while the neck area is cleaned and prepared.
- Imaging guidance such as ultrasound is used to identify the stellate ganglion.
- A fine needle is carefully positioned near the nerve cluster.
- A small amount of local anaesthetic is injected.
- You will be monitored for a short period before going home the same day.
The injection itself usually takes only a few minutes, although the total appointment time may be longer due to preparation and monitoring.
How SGB may help with PTSD symptoms
By temporarily blocking nerve signals in the stellate ganglion, SGB may help reduce excessive activity in the sympathetic nervous system.
For some patients, this may lead to improvements in symptoms related to the body’s stress response, such as:
- Improved sleep
- Reduced anxiety
- Less hypervigilance
- Improved emotional regulation
Some people report noticing improvements within days of treatment, while others may experience more gradual changes. In some cases, more than one treatment may be recommended.
Responses vary between individuals, and SGB does not work for everyone.
Is Stellate Ganglion Block right for everyone?
SGB is not typically the first treatment recommended for PTSD.
Most clinical guidelines continue to recommend treatments such as:
- Trauma-focused cognitive behavioural therapy (CBT)
- EMDR (Eye Movement Desensitisation and Reprocessing)
- Certain medications prescribed by a doctor
For individuals whose symptoms remain severe despite these treatments, SGB may be considered as part of a multidisciplinary treatment approach.
A specialist physician will assess your medical history, current symptoms, and previous treatments to determine whether the procedure may be appropriate.
Considering treatment
Living with PTSD can be challenging, and treatment often involves a combination of approaches tailored to the individual.
If your symptoms have not improved with standard therapies, discussing additional options with your healthcare provider may be helpful.
At Monash House Private Hospital, our experienced specialists provide a comprehensive assessment and work closely with patients and their treating clinicians to determine the most appropriate care plan.
Frequently asked questions
Is Stellate Ganglion Block safe?
SGB has been used for decades to treat certain pain conditions. When performed by an experienced physician using imaging guidance, the procedure is generally considered safe, although all medical procedures carry some risks.
How long does the treatment take?
The injection itself usually takes only a few minutes, although patients are monitored afterwards before going home.
Will one treatment cure PTSD?
SGB is not considered a cure for PTSD. It may help reduce certain symptoms and is typically used alongside psychological therapies and other treatments.
References
- Rae Olmsted KL et al. Effect of Stellate Ganglion Block Treatment on PTSD Symptoms: A Randomized Clinical Trial. JAMA Psychiatry. 2019.
- Peterson K et al. Evidence Brief: Effectiveness of Stellate Ganglion Block for PTSD. U.S. Department of Veterans Affairs.
- Piraccini E et al. Stellate Ganglion Blocks. StatPearls Publishing.
- Cleveland Clinic. Stellate Ganglion Block: Uses, Risks and Benefits.
- Yang Y et al. Stellate ganglion blockade for PTSD: systematic review.
