Stellate ganglion block (SGB) at PHI is an image-guided injection of local anesthetic beside the stellate ganglion, a cluster of fight-or-flight nerves in the front of the neck. Board-certified physicians Dr. Faisal Lalani and Dr. Nadiv Samimi perform it in our affiliated surgical suite at 455 N Roxbury Drive, Suite B, Beverly Hills. It relieves PTSD and anxiety symptoms, often within 30 minutes, and treats nerve pain in the arm, head and face. Veterans receive a discount on SGB for PTSD.
What SGB Treats
Stellate ganglion block treats the symptoms of anxiety, long-term pain syndromes and stress disorders. Today it is best known for post-traumatic stress disorder (PTSD). Emerging research shows SGB helping veterans and service members recover from PTSD, including after the return to civilian life. [1]
PHI uses SGB for two groups of patients. For people living with PTSD or severe anxiety, it quiets a stress response that never switched off. For people with nerve pain in the arm, head or face, including complex regional pain syndrome (CRPS), it both pinpoints the source of the pain and relieves it. [2]
How PTSD Keeps the Body on Alert
PTSD develops after exposure to extreme stress, a serious injury or sexual trauma. It brings a mix of psychiatric symptoms, among them nightmares, severe anxiety, insomnia, hypervigilance and overreacting to everyday triggers.
The sympathetic nervous system, the body’s fight-or-flight system, has long been known to play a part. After extreme trauma, extra nerves in this system are believed to sprout and grow. They raise levels of norepinephrine, an adrenaline-like chemical, which overstimulates the amygdala, the brain’s fear center. That chain of events can keep PTSD symptoms going for years.
How a Stellate Ganglion Block Works
The stellate ganglion is a collection of sympathetic nerves that sits in front of the vertebrae in your neck. Placing a local anesthetic on it interrupts the fight-or-flight signals that run through it. For PTSD, that can relieve symptoms in as little as 30 minutes, with relief that can last for years.
The research behind it keeps growing. In a randomized trial with active-duty service members, SGB reduced PTSD symptoms significantly more than a placebo procedure. [1] A 2025 review that pooled the controlled trials found that SGB eased PTSD symptoms. [3] Across published studies, patients improved within minutes of the block, and the improvement lasted a month or longer. [4]
What Patients Notice After SGB
The benefits patients describe after a stellate ganglion block for PTSD:
- Treats PTSD and post-traumatic stress injury (PTSI)
- Restores emotional and mental clarity
- Improves sleep and reduces insomnia
- Restores healthy autonomic function to the nervous system
- Improves memory and concentration
- Boosts sexual function and intimacy
- Eases the on-edge feeling and other forms of social anxiety
- Makes it easier to connect and interact with people
- Treats panic attacks
Who SGB Helps
SGB can help anyone living with the symptoms of PTSD. Many of our patients carry stress from work that puts them in harm’s way:
- Veterans
- First responders
- Police officers
- Firefighters
It also helps people with severe anxiety, whatever its source.
Stellate Ganglion Block for Nerve Pain
Long before it was used for PTSD, SGB was a standard tool in pain medicine. As a diagnostic test, it shows whether nerve pain in the arm or head is coming from the sympathetic nerves, and it helps confirm complex regional pain syndrome. Given as a series, it relieves neuropathic pain in the arms and face. [2]
The pain conditions it treats include complex regional pain syndrome of the arm, hand, head or neck, phantom limb pain, chronic pain after surgery, shingles pain that lingers (postherpetic neuralgia) and facial pain. [2] For pain, patients often receive a series of blocks, and a clear response helps your physician choose the next step.
SGB and Ketamine Together
Few practices offer both SGB and ketamine infusion therapy. PHI does, and the two work through different pathways. SGB calms the fight-or-flight system that keeps hyperarousal going. Ketamine works on the pathways behind depression, anxiety and intrusive thoughts.
Patients whose days are ruled by a racing heart, hypervigilance, an exaggerated startle or poor sleep often start with SGB. Many patients have both patterns, and combined treatment can address both. We work out the order with you at consultation.
A Discount for Veterans
We honor our veterans with an exclusive discount on stellate ganglion block for PTSD. Let us know you served when you reach out.
Why PHI for Stellate Ganglion Block
Image-guided, every block
Every SGB is performed under image guidance in our affiliated surgery center, with monitoring and emergency-trained staff present.
Two board-certified physicians
Dr. Faisal Lalani and Dr. Nadiv Samimi, both trained in interventional pain at Cedars-Sinai, where Dr. Lalani is on the faculty.
SGB and ketamine under one roof
PHI offers both, so treatment can follow your symptom pattern, one at a time or together.
Care that works with your therapist
We coordinate with your psychiatrist, therapist or other mental health providers, so the block supports the care you already have.
A short, private intake
A confidential questionnaire comes first. We ask only what we need, and we never ask you to describe your trauma in detail.
A discount for veterans
Veterans receive an exclusive discount on stellate ganglion block for PTSD.
Keeping the Results Going
Patients do best when they follow an aftercare plan under the supervision of psychiatric professionals. Cognitive behavioral therapy (CBT), reducing or stopping psychiatric medications with your prescriber’s guidance, and meditation are commonly recommended.
SGB is not a cure for PTSD, but it can keep symptoms under control for a long time. Symptoms can return after a new trauma, in people who are genetically sensitive to stress, or when the aftercare plan is not followed. If they do, another block is likely to relieve them again.
Is SGB Right for You?
SGB tends to be a strong fit when:
- You live with PTSD or severe anxiety, and therapy and medication have helped but not enough
- You see a therapist, psychiatrist or other mental health provider, or you are ready to start
- Hyperarousal runs your day, with a racing heart, feeling on guard, startling easily or sleeping poorly
- You have nerve pain in the arm, head or face, including CRPS, that other treatments have not settled
Talk with us before booking if:
- You are in active crisis right now (call or text 988 first)
- You take a blood thinner, since it may need to be paused before the block
- You have not yet tried therapy or medication aimed at PTSD
Your SGB Visit, Step by Step
Questionnaire and consultation
Start with our confidential PTSD and anxiety questionnaire. At consultation, your physician reviews your history, current medications and mental health care, and confirms SGB is a good fit. Some medications, including certain blood thinners, may need to be paused, and you will get specific instructions.
The block
You stay awake while your physician uses image guidance to place local anesthetic beside the stellate ganglion. It typically takes 10 to 20 minutes. PHI treats one side at a time, never both on the same day.
Recovery
You rest in our recovery area for about 30 to 60 minutes. A temporary droopy eyelid, slight redness and warmth on the treated side are expected signs the block is working, and they fade within several hours. Arrange a ride home, since you should not drive for 24 hours.
Feeling the change
Many patients notice a calmer baseline, less hyperarousal and better sleep within the first week.
Follow-up
Your physician checks in on your response. If relief starts to fade, another block is an option.
Questions About SGB
In as little as 30 minutes for many patients. Most who respond notice a calmer baseline, less hyperarousal and better sleep within the first week.
Relief can last for years. If symptoms return, another block is likely to relieve them again, and following your aftercare plan helps the results hold.
No, but it can control symptoms for a long time. It works best alongside ongoing care from your mental health team, such as therapy and medication management.
One side at a time, never both on the same day. If your physician recommends a second block, it is spaced out on its own visit.
A droopy eyelid, slight redness and warmth on the treated side are expected and fade within several hours. Serious complications are uncommon when an experienced physician performs the block under image guidance, and your physician reviews the specific risks with you at consultation.
Most patients describe it as briefly uncomfortable. Local anesthetic numbs the skin first, and the block itself takes 10 to 20 minutes.
Generally no. Most patients continue their current medications. Any later change to psychiatric medications happens with your prescriber’s guidance as part of aftercare.
No. We need to know about your diagnosis, the treatments you have tried and the symptoms you have now. Trauma-focused work happens in your therapy, not at our consultation.
Yes. Veterans receive an exclusive discount on stellate ganglion block for PTSD. Let us know you served when you reach out.
SGB for PTSD is a cash-pay service, and insurance coverage is typically not available. Pricing is reviewed at consultation.
Coverage for pain conditions such as CRPS varies. We provide documentation so you can seek reimbursement through your out-of-network benefits, and all pricing is reviewed at consultation.
Yes. SGB calms the fight-or-flight system, while ketamine works on the pathways behind depression, anxiety and intrusive thoughts. Some patients benefit from both, one after the other or together, and we plan this at consultation.
Yes. PHI regularly treats patients from Las Vegas, Palm Springs, London and beyond, and we can coordinate your consultation and block around your travel.
Start With the PTSD and Anxiety Questionnaire
To schedule a stellate ganglion block, begin with our confidential PTSD and anxiety questionnaire. It scores your PTSD and anxiety symptoms right on the page, and you can print your results to bring to your consultation. You can also call us at (310) 856-9488.