Novel PTSD Treatment – Stellate Ganglion Block

PTSD is a mental health condition that’s triggered by a terrifying event; either by experiencing it or by witnessing it. Over the years it has been known as shell shock, combat fatigue, soldier's heart, nostalgia, and war neurosis and has been around for centuries. While it is best known from war related atrocities, it also can occur from witnessing or experiencing a severe traumatic event such as terrorism, serious accidents, natural disasters, personal assault such as rape, child abuse, or being a victim of a crime.

Symptoms may include:

What causes PTSD?

The primary mechanism involves the amygdala and the stellate ganglion of the sympathetic nervous system. Witnessing or experiencing a traumatic event will set the amygdala into fight or flight mode. In some, this later becomes PTSD.

What is the Amygdala and Stellate Ganglion and what do they do?

The amygdala stores very strong emotions associated with the traumatic memories. We have two, one in each temporal lobes of our brains. We are not talking about your run of the mill emotion that gets stored here. We are talking about such an emotion that your brain really wants you to remember. It may be fear such as being chased by a barking, angry dog. This memory serves an important purpose to trigger a fight or flight response in a similar circumstance. However, with severe and traumatic events and the resulting memories and emotions overwhelm the amygdala. These traumatic memories cause the amygdala to fire off signals and to the person with PTSD it seems as if it is happening right here and right now. A sound, an image, a smell can all trigger this.

The stellate ganglion is part of the sympathetic nervous system. It communicates with the amygdala. Due to the traumatic memories now stored in amygdala, it is constantly sending signals to the stellate ganglion and the cervical sympathetic chains in your neck. It keeps the sympathetic nervous system tone very high instead of balanced. Think of it like a bucket filled to the brim and it always stays full. It doesn't take much to trigger the fight or flight response. Every time a triggering memory of an associated smell, sight, or sound is heard, it triggers this response. Because the bucket is always full, it makes you feel hypervigilant. You avoid certain places and activities due to anxiety and fear. It is a horrible and exhausting way to exist. You are not even safe during sleep due to nightmares and night terrors. This is the essence of PTSD.

If you are experiencing even half of these symptoms, you should know that there is a successful treatment available called the Stellate Ganglion Block (SGB).

How is PTSD treated?

The mainstay of PTS therapy has been medications such as antidepressants and psychotherapy. These are often not very effective alone partly due to participants dropping out of therapy, as many psychotherapies require one to relive or talk about the traumatic event causing many of the symptoms above. The goal always has been and always will be to reduce the risk of suicide and to regain function.

Are there more effective treatments available?

There are other treatment options for PTSD. One is a Stellate Ganglion Block (SGB). This injection is not new and has been around since the 1920’s. It was originally used for pain and still is. The SGB was found by accident to treat depression in the 1940’s, and similarly, to treat PTSD in the 1990’s.

How does the SGB work?

The SGB is an injection that became famous when Dr. Sean Mulvaney, a military pain doctor, appeared on 60 minutes discussing its usefulness in treating PTSD in late 2019. This injection can be performed with x-ray fluoroscopic or ultrasound image guidance and is performed by directing a needle to a nerve bundle sitting near the cervical spine in your neck. It is a safe procedure in experienced hands.

The SGB works by blocking the emotional response caused by the triggering event, thoughts, nightmares, or sounds. It may even reset the amygdala altogether. Studies show that it has been very successful at restoring the normal functioning of the amygdala and the stellate ganglion to pre-trauma settings. Patients often feel very calm and relaxed immediately following this injection. Most often, we block the right SGB because the right side of the amygdala appears to be more responsible for the emotions associated with PTSD. Occasionally, a left sided SGB is needed as well. Sometimes the reset is long-lasting. Other times, the injection will need to be repeated.

While the SGB blocks the abnormal and constant signals originating in the amygdala, it won't prevent actual normal sympathetic responses from getting thru for actual fight or flight if needed.

To summarize, the SGB works to reduce or eliminate the anger, fear, anxiety, depression, sadness, hypervigilance, and the fight or flight response associated with PTS. It does NOT remove or reduce the thoughts or the nightmares, just the emotional response to them. Psychotherapy and treatments such as EMDR in conjunction with the SGB may be much more effective at processing thru the traumatic event and memories after the injection.

Our experts at Southwest Pain Management in Irving offer this injection treatment for people suffering with PTSD.

Some studies supporting the SGB treatment for PTSD

AUTHOR: Dr. Robert Groysman, MD

Dr. Robert Groysman is a Diplomate of the American Board of Anesthesiology and American Board of Pain Medicine, and a proud member of the Texas Pain Society, American Society of Interventional Pain Physicians, and Spine Intervention Society. He participates in research, frequently attends professional conferences, and continually adopts new procedures and techniques for relieving pain into his practice at Southwest Pain Management.

What is Post Traumatic Stress Disorder?

PTSD is a mental health condition that’s triggered by a terrifying event; either by experiencing it or by witnessing it. Over the years it has been known as shell shock, combat fatigue, soldier's heart, nostalgia, and war neurosis and has been around for centuries. While it is best known from war related atrocities, it also can occur from witnessing or experiencing a severe traumatic event such as terrorism, serious accidents, natural disasters, personal assault such as rape, child abuse, or being a victim of a crime.

Symptoms may include:

What causes PTSD?

The primary mechanism involves the amygdala and the stellate ganglion of the sympathetic nervous system. Witnessing or experiencing a traumatic event will set the amygdala into fight or flight mode. In some, this later becomes PTSD.

What is the Amygdala and Stellate Ganglion and what do they do?

The amygdala stores very strong emotions associated with the traumatic memories. We have two, one in each temporal lobes of our brains. We are not talking about your run of the mill emotion that gets stored here. We are talking about such an emotion that your brain really wants you to remember. It may be fear such as being chased by a barking, angry dog. This memory serves an important purpose to trigger a fight or flight response in a similar circumstance. However, with severe and traumatic events and the resulting memories and emotions overwhelm the amygdala. These traumatic memories cause the amygdala to fire off signals and to the person with PTSD it seems as if it is happening right here and right now. A sound, an image, a smell can all trigger this.

The stellate ganglion is part of the sympathetic nervous system. It communicates with the amygdala. Due to the traumatic memories now stored in amygdala, it is constantly sending signals to the stellate ganglion and the cervical sympathetic chains in your neck. It keeps the sympathetic nervous system tone very high instead of balanced. Think of it like a bucket filled to the brim and it always stays full. It doesn't take much to trigger the fight or flight response. Every time a triggering memory of an associated smell, sight, or sound is heard, it triggers this response. Because the bucket is always full, it makes you feel hypervigilant. You avoid certain places and activities due to anxiety and fear. It is a horrible and exhausting way to exist. You are not even safe during sleep due to nightmares and night terrors. This is the essence of PTSD.

If you are experiencing even half of these symptoms, you should know that there is a successful treatment available called the Stellate Ganglion Block (SGB).

How is PTSD treated?

The mainstay of PTS therapy has been medications such as antidepressants and psychotherapy. These are often not very effective alone partly due to participants dropping out of therapy, as many psychotherapies require one to relive or talk about the traumatic event causing many of the symptoms above. The goal always has been and always will be to reduce the risk of suicide and to regain function.

Are there more effective treatments available?

There are other treatment options for PTSD. One is a Stellate Ganglion Block (SGB). This injection is not new and has been around since the 1920’s. It was originally used for pain and still is. The SGB was found by accident to treat depression in the 1940’s, and similarly, to treat PTSD in the 1990’s.

How does the SGB work?

The SGB is an injection that became famous when Dr. Sean Mulvaney, a military pain doctor, appeared on 60 minutes discussing its usefulness in treating PTSD in late 2019. This injection can be performed with x-ray fluoroscopic or ultrasound image guidance and is performed by directing a needle to a nerve bundle sitting near the cervical spine in your neck. It is a safe procedure in experienced hands.

The SGB works by blocking the emotional response caused by the triggering event, thoughts, nightmares, or sounds. It may even reset the amygdala altogether. Studies show that it has been very successful at restoring the normal functioning of the amygdala and the stellate ganglion to pre-trauma settings. Patients often feel very calm and relaxed immediately following this injection. Most often, we block the right SGB because the right side of the amygdala appears to be more responsible for the emotions associated with PTSD. Occasionally, a left sided SGB is needed as well. Sometimes the reset is long-lasting. Other times, the injection will need to be repeated.

While the SGB blocks the abnormal and constant signals originating in the amygdala, it won't prevent actual normal sympathetic responses from getting thru for actual fight or flight if needed.

To summarize, the SGB works to reduce or eliminate the anger, fear, anxiety, depression, sadness, hypervigilance, and the fight or flight response associated with PTS. It does NOT remove or reduce the thoughts or the nightmares, just the emotional response to them. Psychotherapy and treatments such as EMDR in conjunction with the SGB may be much more effective at processing thru the traumatic event and memories after the injection.

Our experts at Southwest Pain Management in Irving offer this injection treatment for people suffering with PTSD.

Some studies supporting the SGB treatment for PTSD

AUTHOR: Dr. Robert Groysman, MD

Dr. Robert Groysman is a Diplomate of the American Board of Anesthesiology and American Board of Pain Medicine, and a proud member of the Texas Pain Society, American Society of Interventional Pain Physicians, and Spine Intervention Society. He participates in research, frequently attends professional conferences, and continually adopts new procedures and techniques for relieving pain into his practice at Southwest Pain Management.

Novel PTSD Treatment – Stellate Ganglion Block

Recent Posts

What is Post Traumatic Stress Disorder?

Symptoms may include:

What causes PTSD?

The primary mechanism involves the amygdala and the stellate ganglion of the sympathetic nervous system. Witnessing or experiencing a traumatic event will set the amygdala into fight or flight mode. In some, this later becomes PTSD.

What is the Amygdala and Stellate Ganglion and what do they do?

How is PTSD treated?

Are there more effective treatments available?

How does the SGB work?

Our experts at Southwest Pain Management in Irving offer this injection treatment for people suffering with PTSD.

Some studies supporting the SGB treatment for PTSD

AUTHOR: Dr. Robert Groysman, MD

What is Post Traumatic Stress Disorder?

Symptoms may include:

What causes PTSD?

The primary mechanism involves the amygdala and the stellate ganglion of the sympathetic nervous system. Witnessing or experiencing a traumatic event will set the amygdala into fight or flight mode. In some, this later becomes PTSD.

What is the Amygdala and Stellate Ganglion and what do they do?

How is PTSD treated?

Are there more effective treatments available?

How does the SGB work?

Our experts at Southwest Pain Management in Irving offer this injection treatment for people suffering with PTSD.

Some studies supporting the SGB treatment for PTSD

AUTHOR: Dr. Robert Groysman, MD

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