Stellate Ganglion Block for Stress, Anxiety, and Nervous System Reset

July 3, 2026; By Benjamin Kosubevsky

For residents of Coral Gables, Key Biscayne, and the broader Miami-Dade corridor, chronic stress and anxiety are not abstract concepts—they are daily realities that erode sleep, concentration, relationships, and professional performance. Many patients in these communities have tried conventional approaches—therapy, SSRIs, benzodiazepines, meditation apps—with incomplete results. When the nervous system itself appears stuck in a state of heightened activation, the question becomes: is there a way to address the hardware, not just the software?

The Stellate Ganglion Block (SGB) is a minimally invasive injection procedure that has been used in medicine for nearly a century and is now generating significant interest in integrative and functional medicine circles for its potential role in modulating the autonomic nervous system. At The Longevity Center FL in West Palm Beach, SGB is administered by our practitioners under image guidance as part of a physician-supervised approach to nervous system wellness.

What Is the Stellate Ganglion?

The stellate ganglion is a cluster of sympathetic nerve cell bodies located at the base of the neck, near the C7 and T1 vertebrae. It is part of the sympathetic nervous system—the branch of the autonomic nervous system responsible for the body’s “fight-or-flight” response. When this system becomes chronically overactivated—whether through sustained psychological stress, trauma, or other factors—it can contribute to a persistent state of physiological hyperarousal that manifests as anxiety, insomnia, elevated heart rate, hypervigilance, and difficulty achieving emotional regulation.

The stellate ganglion block involves injecting a local anesthetic (typically procaine) directly adjacent to the stellate ganglion under fluoroscopic or ultrasound guidance. The procedure has been used in pain medicine for decades and has been described in the peer-reviewed literature as a safe, well-tolerated procedure with a long clinical track record (Lipov et al., Medical Hypotheses, 2009).

The Research on SGB and the Sympathetic Nervous System

Interest in SGB for anxiety, PTSD, and autonomic dysregulation has grown substantially in recent years. A randomized controlled trial published in JAMA Psychiatry evaluated SGB in active-duty military service members with PTSD and found that participants who received SGB showed a clinically meaningful and statistically significant reduction in PTSD symptom scores compared to a sham injection group (Rae Olmsted et al., JAMA Psychiatry, 2020). This was a landmark study because it was one of the first large, double-blind, sham-controlled trials to evaluate SGB specifically for PTSD.

The proposed mechanism of action involves a temporary interruption of sympathetic nerve signaling at the stellate ganglion, which is hypothesized to allow the autonomic nervous system to “reset” from a state of chronic hyperactivation to a more balanced baseline. Published research has described this as a potential way to reduce sympathetically mediated symptoms such as elevated heart rate, anxiety, sleep disruption, and hypervigilance (Lipov et al., Medical Hypotheses, 2009).

What SGB May Be Appropriate For

At The Longevity Center FL, our practitioners evaluate SGB candidacy on a case-by-case basis. Based on the current evidence and clinical experience, SGB is most commonly discussed in the context of:

• Chronic anxiety or panic-like symptoms that have not fully responded to conventional approaches, including therapy and medication
• Post-traumatic stress—whether from a single event or cumulative life stressors—that manifests as hypervigilance, sleep disruption, emotional dysregulation, or exaggerated startle response
• Autonomic dysregulation characterized by elevated resting heart rate, excessive sympathetic tone, or difficulty downregulating the stress response
• Chronic insomnia driven by nervous system hyperactivation rather than behavioral or sleep hygiene factors

It is important to emphasize that SGB is not presented as a cure for anxiety, PTSD, or any mental health condition. It is one component of a comprehensive approach that may also include therapy, lifestyle modification, hormone optimization, and other wellness strategies.

What to Expect During the Procedure

SGB is performed in our clinic as an outpatient procedure. The patient is positioned comfortably, and the skin is cleaned and prepped. Using real-time ultrasound or fluoroscopic guidance, our practitioner identifies the stellate ganglion and delivers a small volume of local anesthetic to the target area. The procedure itself takes approximately 10 to 15 minutes. Most patients describe mild pressure at the injection site but minimal pain.

Following the injection, patients are monitored in the clinic. Common temporary effects include a drooping eyelid (ptosis), nasal congestion, and warmth in the hand on the injected side—all of which are expected signs that the block has reached the stellate ganglion and typically resolve within a few hours.

Safety and Side Effects

SGB has been performed for nearly a century and has a well-documented safety profile when administered by trained practitioners under image guidance. The most commonly reported side effects are the expected temporary effects described above (ptosis, nasal congestion, warmth). Rare but possible complications include hoarseness, difficulty swallowing, and—very rarely—pneumothorax or vascular injury, which is why image guidance is considered essential.

Accessibility for Coral Gables and Key Biscayne Residents

The Longevity Center FL is located at 580 Village Blvd, Suite 210 in West Palm Beach. Residents of Coral Gables can reach our clinic in approximately 75 minutes via I-95; Key Biscayne residents in approximately 80 minutes. For patients traveling from Miami-Dade, we can often accommodate scheduling that minimizes return trips.

If you are living with chronic stress, anxiety, or nervous system dysregulation and have not found adequate relief through conventional approaches alone, SGB may be worth discussing with our team. We welcome the opportunity to evaluate whether this procedure is clinically appropriate for your individual situation.

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References

1. Rae Olmsted KL, Bartoszek M, Mulvaney S, et al. Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial. JAMA Psychiatry. 2020;77(2):130-138. [Full Text]
2. Lipov EG, Joshi JR, Sanders S, Slavin KV. A Unifying Theory Linking the Prolonged Efficacy of the Stellate Ganglion Block for the Treatment of Chronic Regional Pain Syndrome (CRPS), Hot Flashes, and Posttraumatic Stress Disorder (PTSD). Medical Hypotheses. 2009;72(6):657-661. [Full Text]