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If you've been living with pain, vascular symptoms, or trauma-related distress that hasn't settled with other treatment, it's understandable to want to know what else is available and whether it might help you.
A stellate ganglion block (SGB) is an ultrasound-guided injection of local anaesthetic around a cluster of nerves in the neck called the sympathetic ganglion or stellate ganglion.
SGB is used in a variety of medical and psychiatric conditions. Our pain management and psychiatry teams offer SGB as one option within a wider assessment, for a range of pain, vascular, and trauma-related psychiatric presentations, including hyperarousal, autonomic symptoms and sleep disruption.
Stellate ganglion block is used to diagnose and treat several conditions. SGB is usually considered when other options have been discussed, tried and failed. The following are some of the medical and psychiatric conditions the SGB can be used for.
SGB is a possible option for pain linked to nerve conditions such as:
SGB may also be discussed for conditions affecting blood flow to the head, neck, or arm, including:
Stellate ganglion block is an established medical procedure that is increasingly being studied as a potential treatment for symptoms associated with post-traumatic stress disorder (PTSD) and treatment-resistant anxiety.
This is an innovative approach is based on the connection between the stellate ganglion and brain regions thought to be abnormally activated in PTSD, such as the amygdala (the brain's threat-detection centre).
At Midland Health, patients are carefully assessed for suitability and the current evidence, potential benefits, limitations and risks are discussed as part of the informed consent process.
Although SGB is not currently recommended by NICE as a standard treatment for PTSD or generalised anxiety disorder, the emerging research is promising. Recent clinical studies, including randomised controlled trials, have reported significant improvements in anxiety and PTSD symptoms in selected patients, particularly symptoms associated with heightened sympathetic nervous system activity such as hyperarousal, disturbed sleep and hypervigilance.
The evidence base continues to develop, and SGB should currently be considered an emerging, adjunctive treatment rather than a replacement for established psychological or medical therapies.
Stellate ganglion block is offered as an addition to established treatment, never a replacement. In the trial that showed benefit, participants continued their usual PTSD care throughout.
It may be worth discussing if you have a confirmed diagnosis of PTSD following full psychiatric assessment, your symptoms are dominated by hyperarousal (feeling constantly on edge, startling easily, poor sleep, strong physical reactions to triggers the symptoms that responded most in the research), you have already tried or are engaged with medication treatment and / or trauma-focused therapy such as Eye Movement Desensitisation Reprocessing, Exposure therapy or Cognitive Processing Therapy.
Where PTSD is the main concern, our mental health team can discuss SGB as something to consider alongside your existing psychotherapy or medication.
Stellate ganglion blocks are also being investigated for generalised anxiety disorder (GAD), but it is still an emerging area of research.
SGB is also sometimes used to treat hyperhidrosis (excessive sweating), Ménière's disease (an inner ear condition affecting balance and hearing), angina pectoris (chest pains) and hot flushes associated with menopause.
For the conditions SGB is used for, it sits across both our Pain Management and Psychiatry clinics.
Understanding which specialist you need can be challenging, especially when symptoms don't fit neatly into one category.
If your main concern is pain or a vascular symptom, our pain management team will assess you first.
If you're exploring SGB for PTSD symptoms, alongside existing trauma-related or psychiatric care, our psychiatry team will talk it through with you as part of that wider picture.
Either route starts with a consultation with the correct specialist, so you can ask questions and understand your options before anything is arranged.
Through this shared clinical care, your history is considered fully before any procedure is discussed
£1100
First Procedure
£850
Follow Up Procedure
£300
(20 min)
£200
(20 min)
£595
(face-to-face or video)
From £1100
A procedure is only arranged once your consultation has confirmed it's an appropriate option for you, and the exact cost will be discussed and agreed with you in advance. Any further investigations or follow-up appointments will also be costed clearly before anything is arranged.
We're recognised by a number of major health insurers. If you plan to use private medical insurance, please contact us ahead of your appointment to confirm your cover.
Your first appointment is a consultation, where you can discuss your symptoms, what's been tried already, and what you're hoping to understand or achieve. If SGB looks like a reasonable option to explore, we'll explain how it's performed, what to expect, and answer any questions you have.
The injection itself is done under ultrasound guidance by our Consultant in Pain Management, Dr Rayen. Using ultrasound, our clinician can see the relevant nerves, muscles, and blood vessels clearly while positioning the needle.
It's carried out on an outpatient basis and typically takes a short time, with a period of monitoring afterwards before you go home. We recommend you come to your appointment with someone one the day so they can ensure you get home safely.
Dr Rayen has over 25 years' experience in pain management. He holds an MSc in Pain Management and Fellowships in Anaesthesia and Pain Medicine, and has particular experience in ultrasound-guided nerve blocks and radiofrequency ablation.
Dr Vaida specialises in medical psychotherapy and general adult psychiatry, with a particular focus on trauma and neurodivergence.
Dr Kudlur specialises in addiction, neuromodulation, and forensic psychiatry, and takes a holistic approach to psychiatric care.
If you have ongoing pain or vascular symptoms in the head, neck, or arm that haven't resolved with other treatment, or if you're already engaged in trauma-focused care and want to explore whether SGB might be a useful adjunct alongside it, SGB may be worth discussing with us
If your main concern is a new or undiagnosed pain problem, our Neuropathic Pain Clinic may be the better first step, so we can build a full picture before considering specific procedures. If PTSD or trauma is your primary concern, and you're not yet linked with a psychiatrist, our Private Psychiatric Clinic is a good place to start that conversation.
You'll be asked about your symptoms, how long they've been present, what's affected them so far, and what matters most to you in terms of day-to-day impact. This helps your clinician understand your situation fully before discussing any next steps.
If SGB is a relevant option, we'll explain:
You're welcome to bring questions, and there's no pressure to decide anything during your first visit.
After a procedure, we'll usually arrange a follow-up so we can hear how you've been and discuss whether any further treatment makes sense. Response to SGB varies between individuals, and some people find a second or repeat injection is worth discussing depending on how the first one goes.
If SGB isn't the right fit for you, or symptoms continue, we'll talk through other options within pain management or psychiatry, so you're not left without a next step.
At our clinic, you’ll receive clear information and time to ask questions.
Your appointments will be held at our clinic at 78-79 Francis Road, Edgbaston, Birmingham, B16 8SP.
We are close to Five Ways train station, accessible by bus, tram, or train. If you're driving, patients can use the Broadway Plaza car park free of charge for up to 2 hours when their vehicle registration is validated at Midland Health reception.
No matter where you're coming from, we aim to make your journey to our clinic as smooth and convenient as possible so you can focus on getting the care you need.
If you'd like to talk through whether SGB might be relevant for you, the first step is a consultation with our pain management or psychiatry team, depending on your main concern.
Do I need a GP referral?
No, you can self-refer to our clinic for either the pain management or psychiatry route.
Is SGB a treatment for PTSD on its own?
No. SGB is not licensed or NICE-approved as a stand-alone treatment for PTSD. Where it’s discussed for trauma-related symptoms, we see it as a possible addition to support your existing psychotherapy or medication, rather than a replacement.
Will I definitely be offered the procedure?
Not necessarily. Whether SGB is suitable depends on your history and symptoms, and your clinician will discuss this with you at your consultation. Some people are better suited to a different approach.
Who might SGB not be suitable for?
SGB may not be appropriate if you have certain bleeding disorders, are taking blood-thinning medication, have an infection near the injection site, or have specific heart or lung conditions. Your clinician will review your medical history with you to check this before any procedure is arranged.
What are the possible side effects of a stellate ganglion block?
Common, usually short-lived effects can include bruising, a temporary drooping eyelid or bloodshot eye, hoarseness, nasal stuffiness, or tingling in the arm, often settling within a few hours.
Rare but more serious risks include infection, nerve injury, or effects on nearby structures in the neck, and these will be discussed with you in detail before you decide whether to go ahead.
How many injections might I need?
This varies between individuals. Some people find one injection is enough to judge whether SGB is helpful for them, while others explore a second or repeat block. Your clinician will discuss what’s reasonable for your situation.
Is this the same as a nerve block for chronic pain generally?
SGB is one specific type of nerve block, targeting the stellate ganglion in the neck. If you have pain elsewhere in the body, a different type of nerve block or approach may be more relevant, which our Neuropathic Pain Clinic can help assess.
Is this covered by health insurance?
We’re recognised by a number of major health insurers. If you intend to use private medical insurance, please contact us ahead of your appointment to confirm your cover.
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Medically Verified
This content has been medically reviewed and verified by Dr Rupa Parmar.
Medical note: This page provides general information and is not a substitute for urgent medical care. If you have severe symptoms, seek urgent help.
Last updated: Sep 2026
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