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Stellate Ganglion InjectionsImage-guided stellate ganglion blocks to interrupt sympathetically maintained pain in the arm, hand, head, and neck — used for CRPS, phantom limb pain, and post-herpetic neuralgia at Remix Medical in Houston, TX.

Specialty
Pain Management
Type
Procedure
Body location
Stellate ganglion, cervicothoracic sympathetic ganglion, C6 and C7 transverse process, upper extremity, head and neck
CPT code
64510 (injection, anesthetic agent; stellate ganglion, cervical sympathetic); 76942 (ultrasound guidance, when reported separately); 77003 (fluoroscopic guidance, when reported separately)

Also known as: Stellate Ganglion Injection, Cervical Sympathetic Block, SGB, Cervicothoracic Ganglion Block

Stellate Ganglion Block in Houston, Texas

The stellate ganglion sits at the base of the neck and governs sympathetic supply to the head, neck, and arm. Blocking it does something that surprises patients: within minutes, the hand warms, the eyelid droops slightly, and pain that has been relentless for months becomes negotiable.

What is a Stellate Ganglion Block?

A stellate ganglion block places local anesthetic onto the cervicothoracic sympathetic ganglion at the level of C6 or C7, under ultrasound or fluoroscopic guidance. It interrupts sympathetic outflow to the upper limb and the face on that side.

It serves as both a diagnostic test for sympathetically maintained pain and, in responders, a therapeutic intervention repeated in a short series.

What It Treats

  • Complex Regional Pain Syndrome (CRPS) of the arm or hand
  • Phantom limb pain after upper-limb amputation
  • Post-herpetic neuralgia of the head, neck, or upper chest
  • Vascular insufficiency of the arm, including Raynaud's phenomenon
  • Refractory angina in selected patients
  • Hyperhidrosis of the hand
  • Post-traumatic stress disorder , an emerging and still-investigational application

Signs the Block Worked

A successful stellate ganglion block produces a recognizable cluster of temporary effects on the treated side, known as Horner's syndrome: a drooping eyelid, a constricted pupil, and reduced facial sweating. The hand becomes visibly warmer. These findings resolve within hours.

They are expected and reassuring, not complications. Their absence suggests the block did not reach the ganglion and that any pain relief should be interpreted cautiously.

A Careful Procedure at Remix Medical

The stellate ganglion sits among the carotid artery, jugular vein, and vertebral artery. This is not a landmark procedure. Contact Remix Medical to schedule a consultation with a board-certified pain management physician in Houston.

How it's performed

The patient lies supine with the neck slightly extended. Under ultrasound or fluoroscopic guidance, the transverse process of C6 or C7 is identified and the carotid artery, jugular vein, and thyroid are visualized and avoided. A needle is advanced to the anterolateral surface of the vertebral body, aspiration excludes vascular placement, and a small test dose precedes the full injection of local anesthetic onto the ganglion. Skin temperature and pupil size are monitored as markers of successful blockade.

How to prepare

Nothing to eat or drink for 6 hours before the procedure. Arrange a driver. Hold anticoagulants only as directed by the prescribing physician. Disclose any history of vocal cord problems, severe COPD, glaucoma, or recent heart attack. Do not schedule a bilateral block.

What to expect after

Do not eat or drink until swallowing and voice are fully normal — usually 4 to 6 hours. Do not drive for the remainder of the day. Expect a droopy eyelid, small pupil, warm hand, and hoarseness on the treated side; these resolve on their own. Schedule physical therapy to fall inside the window of pain relief. Report difficulty breathing, chest pain, severe neck swelling, or a rapidly expanding neck mass immediately.

Outcome

A successful block produces immediate warming of the hand and temporary Horner's syndrome on the treated side, confirming sympathetic blockade. In sympathetically maintained pain, patients typically experience substantial short-term relief that enables intensive physical therapy — the combination that drives functional recovery.

Your physician

Your pain management at Remix Medical.

Every clinician at Remix Medical is board-certified and owns the practice — so the physician in your exam room is the one making decisions about your care.

  • Raju Mantena, DO

    Pain Medicine Physician

    Medical Center — South Freeway · Montrose — Upper Kirby · Pearland

    Board certifiedAccepting newBook

This page is for general education and is not a substitute for medical advice. Whether a given procedure is appropriate depends on your individual evaluation. Contact a Remix Medical clinician to discuss your care.

Updated July 9, 2026.

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