Stellate Ganglion Block for PTSD

Individuals may develop PTSD (also called Post Traumatic Stress Injury) from a single or repeated traumatic events. When trauma causes a persistent injury pattern to the nervous system, it can become locked into a permanent protective mode, even in the absence of on-going threat. This can cause a variety of symptoms including:

• Being "on-guard" all the time
• Constant anxiety and fear
• Intolerance of being around groups of people
• Nightmares
• Isolation from others physically and emotionally
• Difficulty progressing in therapy because talking about the trauma makes you too anxious

What is a stellate ganglion block?

The sympathetic nervous system (the "fight or flight" part of the nervous system) is organized in front of the spinal column. Along the spine there are nerve bundles referred to as ganglion. Several ganglia are located in the neck, including one in the lower neck called the stellate ganglion. These nerves are special for their connection to brain regions which store and control emotional memories. Injection of local anesthetic around these nerve bundles interrupts the nervous system's constant exaggerated response to emotional trauma. You can think of it like rebooting your computer.

How is a stellate ganglion block done?

For decades, the procedure was done by feeling for a particular bone in the front of the spine, pushing the carotid artery toward the middle with one hand, and inserting a needle until it contacted bone prior to injection. Later, the procedure was improved by the use of x-ray to verify the correct level of the spine. However, use of x-ray does not allow visualization of important nerves and arteries in the neck.

Ultrasound imaging and needle guidance is the gold standard for accuracy and safety, and the only technique Dr. Vogel has used over the last 7 years. The procedure is 1-2 minimally painful injections done in an outpatient setting that takes about 15 minutes.

What should I expect after the injection?

People typically note alleviation of PTSD symptoms within 15 minutes. Although the anesthetic wears off after 4-6 hours, symptoms are usually greatly reduced for weeks, months or longer.

What is Dr. Vogel's experience with this procedure for Post-Traumatic Stress Injury?

Until January 2020, Dr. (Colonel) Vogel served as an active-duty US Army physician providing specialty pain care to Soldiers, Marines, Sailors, Airmen and Coasties. He has treated men and women with combat trauma, those who have been sexually assaulted, physically or emotionally abused, or have had other traumatic experiences with lingering effects. He was trained to use this procedure by the foremost experts in the world - his fellow US Army physicians. He continues to provide this treatment in his civilian practice.

Does Dr. Vogel use this procedure for other conditions?

Yes, there is evidence that Stellate Ganglion Blocks can be used to treat symptoms of Traumatic Brain Injury, Long COVID symptoms called dysautonomia, Parosmia (distorted or lost sense of smell), poorly controlled anxiety and phobias. The procedure has also been used for a long time for many different pain conditions such as Complex Regional Pain Syndrome, head and facial pain, post-herpetic neuralgia and more.