Stellate Ganglion Block (SGB) Therapy for Post Traumatic Stress Disorder (PTSD)

UPDATE: We are seeing patients at our Bellevue WA office during the COVID-19 / Coronavirus pandemic. Contact us to book an appointment or read more here.

We are proud to offer Stellate Ganglion Block (SGB) therapy for people diagnosed with Post Traumatic Stress Disorder (PTSD).  Both of our Board Certified pain-management physicians, Dr. Jason Attaman and Dr. Cameron Cartier, perform this medical treatment for PTSD.  (Dr. Cartier is an Air Force veteran who served 3 years of active duty, including in Afghanistan.)  Unlike many psychotherapy-based approaches to overcoming PTSD, stellate ganglion block is purely a medical procedure. It is fast-acting and only requires one or two visits to the clinic.

We offer a 40% discount to US Military veterans, active-duty personnel, and law enforcement. (Many of our patients come from nearby Joint Base Lewis-McChord.)

Contact us today to schedule an appointment at our Bellevue or Seattle office, or read on to find out more about stellate ganglion block as a possible treatment option for PTSD.

The Stellate Ganglion Block (SGB) Procedure for Post Traumatic Stress Disorder (PTSD).

The Stellate Ganglion Block (SGB) Procedure for Post Traumatic Stress Disorder (PTSD).

What is PTSD?

Post-Traumatic Stress Syndrome (PTSD) is a disorder characterized by a heightened response to a traumatic event in the past. This can result in feelings of persistent stress, anxiety, and fear, even when there is no immediate danger present. Those who suffer from PTSD often avoid situations that remind them of the traumatic event or place and may experience flashbacks. Military members who have seen combat are at risk for developing PTSD and this disorder can be difficult to treat and may even prevent them from living a normal life. It is often treated with various forms of therapy, medication, and, at times, stellate ganglion block injections.

What is a Stellate Ganglion Block (SGB), and how does it relate to PTSD?

The stellate ganglion is a bundle of nerves that is located deep in the lower neck. It is located within the cervical sympathetic chain. Sympathetic nerves play a strong role in our fight-or-flight response. Injecting local anesthetic (numbing medicine) around these nerves is called a stellate ganglion block (SGB). SGB can help reset these nerves that are thought to be chronically in fight-or-flight response. Stellate ganglion block (SGB) injections need to be performed under either ultrasound and/or fluoroscopic guidance as there are major blood vessels and organs nearby. The SGB injection is not new and has been used for decades to treat conditions such as chronic regional pain syndrome (CRPS) of the upper extremity. More recently, SGB is being used to treat PTSD.

The only physicians that are formally trained in the SGB procedure are Interventional Pain Management physicians. Physicians such as Dr. Attaman and Dr. Cartier learn how to safely perform SGB during a year-long advanced training program called a Pain Medicine fellowship. A fellowship is the highest level of training a physician can complete and is done after medical school, internship, and residency. Stellate ganglion block is a technically demanding procedure that requires precise image guidance using an ultrasound machine and sometimes a form of x-ray called a fluoroscope. We generally prefer to use ultrasound as it allows us to better visualize nerves, arteries and veins in this delicate area. You may wonder why some physicians use ultrasound while others use fluoroscopy. The answer is fairly simple; it is much safer and accurate to use ultrasound but much more difficult to learn this method. Fluoroscopy is faster but does not allow for the visualization of delicate nerves and blood vessels in the area. The procedure is non-painful (it hurts about as much as a flu shot), as it involves only a single needle poke in the side of the neck after numbing the skin.

Recent Research

Several studies have been performed in the past, analyzing the effectiveness of stellate ganglion block (SGB) for the treatment of PTSD. Although some results were favorable, the level of research was not ideal. Very recently, however, the first multi-site, randomized control trial was published the Journal of the American Medical Association (JAMA). The results suggest that two stellate ganglion blocks two weeks apart can help reduce symptoms related to PTSD. You may read the study below.

In the Media

Watch the two recent broadcasts about SGB for PTSD from 60 Minutes and CBS this Morning, below.

Dr. Cartier’s Military Experience

During my active-duty service as a Major in the Air Force as a pain specialist and anesthesiologist, I treated active duty members and veterans who suffered from PTSD. While on tour in Afghanistan, I worked alongside those who had served multiple tours in combat zones and saw the negative impact PTSD can have. I was fortunate to perform stellate ganglion blocks on our soldiers and saw first-hand the positive effect it had on their mental health. Now that I’m a veteran myself, it’s my hope that I can continue to perform procedures such as this that can help those with PTSD improve their quality of life.

Take-Home Message

PTSD is a potentially debilitating problem for anyone who has suffered a major traumatic event in their lives, not just military members. Stellate ganglion blocks have shown promising results in recent studies and those who suffer from PTSD are encouraged to discuss the SGB procedure with a highly-trained physician. It is also important to know these injections are just one component of the treatment regimen and that continued therapy and medications under the direction of a mental health care professional are needed as well.