A stellate ganglion block may help evaluate or temporarily reduce selected CRPS, upper extremity pain, autonomic symptoms, or complex pain patterns.
Learn how Dr. Siefferman performs stellate ganglion blocks to help treat chronic nerve pain, complex regional pain syndrome (CRPS), and certain head, neck, and upper extremity pain conditions.
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Hi, I’m Dr. Jason Siefferman, interventional pain specialist at Manhattan Pain Medicine. The stellate ganglion is the sympathetic ganglion located right around the base of the neck which is responsible for sensitization of the head, neck, and arm. We will block this ganglia if there is any sympathetically mediated pain in these areas or if we’re treating PTSD.
That fight or flight response goes through those exact same pathways as the pain for the sympathetic nervous system. And to do this procedure, we’ll have the patient laying on their back with the head turned slightly to the side. We will use ultrasound guidance to identify the level. There’s cold spray to numb the skin, a little poke, and then we put numbing medicine around the stellate ganglion.
Generally, we use lidocaine so that there’s a numbing effect for 1 hour, but the result is a reboot of the nervous system, which can last days, weeks, or months. Everyone’s response is a little bit individual, and the pattern of response tells us more about what’s driving the sensitization in the first place
A stellate ganglion block is a targeted sympathetic nerve block performed near the stellate ganglion, a nerve structure in the neck that can influence pain signaling, circulation, sweating, temperature, and autonomic responses in the head, neck, upper chest, and upper extremity. It may be considered for selected patients with CRPS, upper extremity pain, autonomic symptoms, post-viral or post-COVID symptom overlap, medical PTSD-related nervous system activation, or complex chronic pain.
At Manhattan Pain Medicine, stellate ganglion block NYC care begins with diagnosis-first evaluation, careful safety screening, and realistic discussion of risks, benefits, alternatives, and expected response.
MPM specialists evaluate whether a stellate ganglion block may be appropriate by reviewing the patient’s symptoms, diagnosis, autonomic features, pain pattern, medical history, medications, and prior treatment response. Upper extremity pain with temperature changes, color changes, sweating changes, swelling, hypersensitivity, or circulation-like symptoms may suggest sympathetic involvement, but similar symptoms can also come from neurological, vascular, inflammatory, musculoskeletal, spine-related, hypermobility-related, or centralized pain mechanisms.
MPM also evaluates post-COVID, POTS-like, medical PTSD, and nervous system activation symptoms carefully because these uses require individualized clinical judgment and realistic expectation-setting.
Patients often search for stellate ganglion block in Manhattan when they have CRPS, upper extremity pain, pain with sweating or temperature changes, autonomic symptoms, post-COVID dysautonomia-type symptoms, medical PTSD symptoms, or complex chronic pain that has not improved with standard care. Many have already tried medication, physical therapy, pain psychology, injections, autonomic care, neurology, or other specialty evaluation.
MPM approaches stellate ganglion blocks as one possible tool within a broader diagnosis-first pain pathway. A block may provide temporary relief, help clarify whether sympathetic pathways are contributing to pain, or support next-step planning. It is not a cure, and it is not appropriate for every patient. When used for PTSD-related symptoms, post-COVID symptoms, or autonomic dysfunction, the evidence and indications require careful discussion. Treatment planning may also include pain psychology, biofeedback, medication management, rehabilitation, autonomic evaluation, neurology, spinal cord stimulation, dorsal root ganglion stimulation, or other neuromodulation options when clinically appropriate.
Stellate ganglion blocks fit within MPM’s Complex Chronic Pain, Autonomic dysfunction, Psychology of Pain, and Headache expertise because many patients have symptoms that involve overlapping pain pathways, autonomic responses, nervous system activation, and functional limitation. A patient may have CRPS, upper extremity pain, post-COVID symptom overlap, POTS-like symptoms, medical PTSD, headache overlap, hypermobility-related complexity, or chronic pain sensitization.
MPM uses stellate ganglion blocks within a coordinated, diagnosis-first model. A block may provide useful information or temporary relief, but it is rarely the entire care plan. Treatment may also include pain psychology, biofeedback, medication management, rehabilitation, autonomic care, neurology, sympathetic blocks, spinal cord stimulation, dorsal root ganglion stimulation, or other neuromodulation options when clinically appropriate.
Before a stellate ganglion block, MPM reviews the diagnosis, symptoms, medications, medical history, risks, alternatives, and post-procedure instructions. The procedure is typically performed with image guidance to help target the stellate ganglion region in the neck. Medication is placed near the sympathetic nerve structure, usually with local anesthetic and sometimes other medication when clinically appropriate.
After the block, patients may notice temporary warmth, redness of the eye, drooping eyelid, nasal congestion, hoarseness, throat sensation changes, swallowing changes, dizziness, or arm heaviness. These effects can be expected in some cases but should be monitored. Relief, if it occurs, may be temporary and varies by diagnosis and patient response. MPM reviews the response to determine whether sympathetic involvement appears clinically meaningful and whether additional treatment should be considered.
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
A stellate ganglion block is an injection near the stellate ganglion, a sympathetic nerve structure in the neck. This structure can influence pain signaling, circulation, temperature, sweating, and autonomic responses in the head, neck, upper chest, and upper extremity. A stellate ganglion block may be considered for selected CRPS, upper extremity pain, autonomic symptoms, post-COVID symptom overlap, medical PTSD-related nervous system activation, or complex pain patterns. At MPM, evaluation comes first.
The stellate ganglion is part of the sympathetic nervous system. It helps regulate certain autonomic functions involving the head, neck, upper chest, and upper extremity, including blood flow, sweating, temperature, and stress-related body responses. In selected pain conditions, sympathetic pathways may contribute to symptoms. MPM evaluates whether the stellate ganglion appears clinically relevant before recommending a block.
A stellate ganglion block places medication near the stellate ganglion to temporarily affect sympathetic signaling. This may help reduce pain or autonomic symptoms in selected patients, or provide diagnostic information about whether sympathetic pathways are contributing to symptoms. Relief is often temporary and varies by diagnosis. MPM uses the response to guide the broader treatment plan, which may include rehabilitation, medication management, pain psychology, biofeedback, or neuromodulation.
Stellate ganglion blocks may be considered for selected patients with upper extremity CRPS, upper body pain with autonomic features, certain circulation-related pain patterns, complex chronic pain, post-viral or post-COVID autonomic symptom overlap, and medical PTSD-related nervous system activation. They are not appropriate for every pain or autonomic condition. MPM evaluates neurological, vascular, inflammatory, musculoskeletal, psychiatric, and centralized contributors before recommending treatment.
A stellate ganglion block may help selected patients with upper limb CRPS, especially when symptoms include burning pain, hypersensitivity, swelling, sweating changes, color changes, temperature changes, or circulation-like features. It does not cure CRPS, and relief may be temporary. However, response to the block may help guide broader care, including physical therapy, desensitization, medication management, pain psychology, spinal cord stimulation, dorsal root ganglion stimulation, or other neuromodulation options.
A stellate ganglion block may be considered for selected upper extremity pain when symptoms suggest sympathetic or autonomic involvement. Upper extremity pain may also come from cervical spine disease, peripheral nerve entrapment, vascular conditions, inflammatory disease, joint pain, muscle pain, CRPS, or central sensitization. MPM evaluates the full pain pattern before recommending a stellate ganglion block or another treatment pathway.
A stellate ganglion block may be considered for selected autonomic symptom patterns when the stellate ganglion appears clinically relevant. Symptoms may include temperature changes, sweating changes, color changes, circulation-like changes, nervous system activation, or post-viral dysautonomia-type complaints. These symptoms can have many causes, including POTS-like syndromes, neurological conditions, vascular issues, endocrine issues, medication effects, and central sensitization. MPM evaluates these possibilities before treatment.
Stellate ganglion block has been studied for PTSD-related symptoms, but evidence is mixed and still evolving. It should not be viewed as a replacement for evidence-based trauma therapy, psychiatric care, or mental health support. In selected patients, MPM may consider whether SGB could fit into a broader care plan for medical PTSD-related nervous system activation, while carefully reviewing safety, expectations, mental health stability, and coordination with appropriate clinicians.
Some patients ask about stellate ganglion block for post-COVID or post-viral dysautonomia-type symptoms. This is an evolving area, and SGB is not a guaranteed or standard solution for post-COVID symptoms. MPM evaluates the patient’s autonomic symptoms, medical history, safety factors, neurological symptoms, cardiopulmonary concerns, and other possible causes before determining whether a stellate ganglion block may be reasonable to discuss.
A stellate ganglion block can be diagnostic, therapeutic, or both. A diagnostic block may help determine whether sympathetic pathways are contributing to symptoms. A therapeutic block is intended to reduce symptoms for a period of time. Relief is often temporary and varies by patient. MPM reviews the degree, timing, duration, and pattern of relief before recommending next steps.
A stellate ganglion block targets a sympathetic structure in the neck and may be considered for selected symptoms involving the head, neck, upper chest, or upper extremity. A lumbar sympathetic block targets sympathetic pathways in the lower back and may be considered for selected lower extremity pain patterns. MPM chooses the target based on pain location, autonomic features, diagnosis, safety factors, and treatment goals.
Relief varies by diagnosis, medication used, block target, and patient response. Some patients may notice temporary relief for hours or days, while others may experience longer improvement. Some patients may not respond. Relief is not guaranteed and does not confirm that the block will provide long-term benefit. MPM uses the response to determine whether sympathetic involvement appears clinically meaningful and whether additional treatment should be considered.
Temporary Horner syndrome can occur after a stellate ganglion block and may include drooping eyelid, smaller pupil, red eye, facial warmth, or reduced sweating on one side of the face. These temporary changes can indicate that the sympathetic pathway was affected. MPM monitors patients after the procedure and reviews which symptoms are expected, which should improve, and which require urgent attention.
Temporary relief can still provide useful diagnostic information. It may suggest that sympathetic pathways are contributing to symptoms. Depending on the response, MPM may consider rehabilitation, medication management, pain psychology, biofeedback, repeat evaluation, spinal cord stimulation, dorsal root ganglion stimulation, or other neuromodulation options. If relief is limited or absent, the diagnosis may need further refinement.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, temporary hoarseness, drooping eyelid, red eye, facial warmth, nasal congestion, trouble swallowing, temporary numbness or weakness, dizziness, low blood pressure, local anesthetic toxicity, vascular injury, nerve irritation, pneumothorax, incomplete relief, temporary relief only, or no relief. MPM reviews risks and safety factors before treatment.
A stellate ganglion block may not be appropriate when symptoms do not suggest sympathetic involvement, when medical or psychiatric instability requires other care first, or when neurological, vascular, infectious, airway, swallowing, cardiopulmonary, or emergency evaluation is needed. It is not a replacement for diagnosis, pain psychology, PTSD therapy, psychiatric care, medication management, physical therapy, autonomic evaluation, neurology, vascular evaluation, surgery, neuromodulation evaluation, or emergency care when needed.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If you are considering a stellate ganglion block in NYC for CRPS, upper extremity pain, autonomic symptoms, post-COVID symptom overlap, medical PTSD-related nervous system activation, headache overlap, or complex chronic pain, MPM can help determine whether this treatment may be appropriate. Your evaluation will consider your diagnosis, symptoms, safety factors, prior care, and goals before any recommendation is made.
A stellate ganglion block is a targeted sympathetic nerve block performed near the stellate ganglion, a nerve structure located in the neck. The stellate ganglion is part of the sympathetic nervous system and can influence pain signaling, blood flow, temperature, sweating, and autonomic responses involving the head, neck, upper chest, and upper extremity.
At Manhattan Pain Medicine (MPM), stellate ganglion block NYC care begins with diagnosis-first evaluation. The goal is to determine whether the stellate ganglion is a clinically reasonable target, whether the procedure can be performed safely, and how the response may guide the broader care plan.
The sympathetic nervous system can become involved in some acute and chronic pain states. In selected patients, pain may be associated with temperature changes, color changes, swelling, sweating changes, hypersensitivity, circulation-like symptoms, or nervous system activation. These features may occur in CRPS and other complex pain conditions.
However, these symptoms are not specific to one diagnosis. Similar features can occur with vascular conditions, neurological disease, inflammatory disease, spine-related pain, peripheral nerve entrapment, hypermobility-related conditions, autonomic dysfunction, post-viral syndromes, medication effects, or central sensitization. MPM evaluates these possibilities before recommending a stellate ganglion block.
A stellate ganglion block may be considered for selected upper limb CRPS or upper extremity pain patterns when sympathetic involvement appears likely. CRPS may involve severe pain, sensitivity, color changes, temperature changes, sweating changes, swelling, stiffness, and movement limitation.
A stellate ganglion block does not cure CRPS. If relief occurs, it may help support participation in rehabilitation, desensitization, physical therapy, medication management, pain psychology, or functional restoration. The response may also help guide discussion of spinal cord stimulation, dorsal root ganglion stimulation, or other neuromodulation options in selected patients.
Some patients ask about stellate ganglion block for autonomic symptoms, medical PTSD-related nervous system activation, or post-COVID dysautonomia-type symptoms. These are complex areas that require careful, individualized evaluation. Evidence for SGB in PTSD and post-COVID symptoms is still evolving, and the procedure should not be presented as a cure or a replacement for evidence-based mental health care, autonomic evaluation, neurology, cardiology, rehabilitation, or primary medical care.
MPM evaluates the patient’s symptom pattern, medical history, psychiatric stability, trauma history, medications, safety factors, and care goals before discussing whether SGB may be reasonable. For some patients, pain psychology, biofeedback, medication management, autonomic care, or specialty coordination may be more appropriate or should be part of the same care plan.
A stellate ganglion block is typically performed with image guidance to help place medication near the stellate ganglion region. Because the target is in the neck, safety screening is important. MPM reviews bleeding risk, infection risk, medication use, swallowing or breathing concerns, neurological symptoms, vascular concerns, and other relevant medical factors.
After the block, temporary effects may include hoarseness, drooping eyelid, red eye, facial warmth, nasal congestion, throat sensation changes, trouble swallowing, dizziness, or arm heaviness. These may occur when the sympathetic pathway is affected, but symptoms should be monitored carefully.
A stellate ganglion block may be diagnostic, therapeutic, or both. A diagnostic block may help determine whether sympathetic pathways are contributing to symptoms. A therapeutic block is intended to reduce symptoms for a period of time.
Relief may last hours, days, weeks, or longer, and some patients do not respond. Temporary relief can still be useful because it may help guide next steps. If symptoms improve in a meaningful way, MPM may consider additional rehabilitation, pain psychology, biofeedback, medication management, repeat evaluation, or neuromodulation planning. If symptoms do not improve, the diagnosis may need refinement.
Risks can include pain flare, bruising, bleeding, infection, allergic reaction, temporary hoarseness, drooping eyelid, red eye, facial warmth, nasal congestion, trouble swallowing, temporary numbness or weakness, dizziness, low blood pressure, local anesthetic toxicity, vascular injury, nerve irritation, pneumothorax, incomplete relief, temporary relief only, or no relief.
Patients should seek urgent evaluation for chest pain, shortness of breath, trouble breathing, trouble swallowing, fainting, new neurological deficits, sudden severe headache, severe neck swelling, worsening voice or swallowing difficulty, limb discoloration, loss of pulses, fever, suspected infection, severe allergic reaction, suicidal thoughts, severe dissociation or psychiatric crisis, or rapidly worsening symptoms.
For selected patients, a stellate ganglion block may be an important part of understanding sympathetic and autonomic contributions to pain. MPM’s role is to determine whether the procedure is appropriate, safe, and aligned with a coordinated care plan.
