Stellate Ganglion Block Long COVID Treatment Shows High Success Rate in Symptom Relief

Stellate Ganglion Block Long COVID Treatment Shows High Success Rate in Symptom Relief

The Albany Clinic • August 11, 2024

Stellate ganglion block (SGB) is gaining attention for treating long COVID symptoms such as fatigue and brain fog. This article explores the effectiveness of stellate ganglion block long COVID treatment, how it works, and its potential benefits for long COVID patients.


Key Takeaways

  • Stellate Ganglion Block (SGB) is showing high success rates in alleviating long COVID symptoms like fatigue, brain fog, and shortness of breath, providing much-needed relief to patients.
  • SGB works by modulating the autonomic nervous system and improving blood flow to the brain, which helps reduce chronic sympathetic hyperactivity and regulate immune and inflammatory responses.
  • Studies, including one by Dr. Luke D. Liu, have shown that 86% of patients experienced a reduction in long COVID symptoms post-SGB treatment, highlighting its potential as a breakthrough therapy.

Understanding Long COVID and Its Symptoms

Long COVID is a term used for an array of new, recurring, or persistent health issues that develop post COVID-19 infection. These issues can vary in nature and severity. Approximately 10% of people experience long COVID symptoms, which can persist for months or even years after the initial infection. The complexity of managing this condition is due to its impact on multiple organ systems. Some common symptoms of long COVID include:

  • Fatigue
  • Shortness of breath
  • Brain fog
  • Muscle and joint pain
  • Chest pain
  • Headaches
  • Loss of taste or smell
  • Sleep disturbances


It is important for individuals experiencing long COVID symptoms to seek medical attention and work with healthcare professionals to manage their condition.


Common symptoms of long COVID include:

  • Fatigue, which may resemble chronic fatigue syndrome (affecting approximately 52.8% of patients)
  • Cognitive disorders, including brain fog and memory impairment (prevalent in about 35.4% of long COVID patients)
  • Musculoskeletal pain (experienced by roughly 27.8% of individuals suffering from long COVID)


These initial symptoms reported, including muscle pain, can severely impact daily life, making even simple tasks challenging due to physical or mental exertion. Despite the prevalent nature of these symptoms, effective treatments for long COVID are surprisingly scarce. This has left many patients in a state of limbo, searching for relief from their debilitating conditions. The introduction of Stellate Ganglion Block as a potential treatment offers a glimmer of hope for those affected by chronic pain management practice.

Illustration of a person experiencing fatigue, brain fog, and muscle pain

What is Stellate Ganglion Block (SGB)?

Stellate Ganglion Block (SGB) is a procedure used to diagnose or treat sympathetically maintained pain, nerve injuries, shingles, or intractable angina. Historically, SGB has been employed in the treatment of various medical conditions such as complex regional pain syndrome and peripheral vascular disease. More recently, it has gained attention for its application in managing post-traumatic stress disorder (PTSD) due to its sedative effects and ability to block neural connections.


In this procedure, a local anesthetic is injected into the stellate ganglion, a nerve cluster in the neck. This block can effectively disrupt the sympathetic nervous system’s signals, providing relief from pain and other symptoms. Given its success in other conditions, researchers are now exploring its potential to alleviate long COVID symptoms, offering a new avenue for relief.

The Mechanism Behind SGB for Long COVID

The promising results of SGB in treating long COVID symptoms can be attributed to its impact on the autonomic nervous system (ANS). SGB can alleviate long COVID symptoms by:


  • Modulating the ANS
  • Correcting sympathetic hyperactivity, a characteristic of long COVID
  • Resetting autonomic function
  • Addressing the chronic sympathetic hyperresponsiveness seen in many long COVID patients.


But how exactly does this work? The answer lies in two primary mechanisms: increased blood flow to the brain and the regulation of immune and inflammatory responses, including the early systemic inflammatory response. We should now examine these intriguing processes in more detail.

Abstract illustration representing Stellate Ganglion Block procedure

Case Studies and Research Findings

The efficacy of SGB in treating long COVID symptoms is supported by compelling research findings. In a study conducted by Dr. Luke D. Liu and Research Coordinator Deborah L. Duricka, the following results were observed:


  • 86% of patients experienced a reduction in their symptoms following SGB treatment
  • Common symptoms assessed included fatigue, brain fog, shortness of breath, and joint pain
  • Fatigue was reported by 85% of participants


These findings provide strong evidence for the effectiveness of SGB in alleviating long COVID symptoms.

The resolution of symptoms such as fatigue and brain fog was often reported within 15 minutes to a few weeks after the SGB procedure. These positive outcomes make SGB a promising treatment option for patients suffering from long COVID syndrome. We should now delve into specific patient improvements and data analysis in greater detail.


Patient Improvements

Following SGB treatment, patients reported immediate or swift alleviation of symptoms, particularly fatigue and brain fog. For instance, a 44-year-old woman with long COVID experienced symptoms like loss of smell and taste, mental fogginess, headache, and shortness of breath. After receiving SGB, she experienced immediate improvement in taste, smell, mental clarity, concentration, memory, and recall.

Only two patients experienced a return of symptoms, with one relapse linked to another viral illness. The highly favorable patient response and noticeable improvement in symptoms underscore the potential of SGB as a breakthrough treatment for long COVID.


Data Analysis and Outcomes

Statistical analysis of the study showed significant symptom relief across various ensuing post acute symptoms in severe trauma patients, including cognitive and respiratory issues, with p-values below 0.001 for most symptoms. The study had limitations such as a small sample size. There was also a potential bias due to only including patients who completed post-procedural follow-up.


Ethical considerations were also paramount, with all patients signing informed consent for the procedure and subsequent data collection. Despite these limitations, the positive outcomes of the study provide a strong foundation for further research into SGB as a treatment for long COVID.

Illustration of a patient experiencing symptom reduction after SGB treatment

Procedure and Safety of SGB

The Stellate Ganglion Block (SGB) procedure involves:

  • Administering an anesthetic at the C6 or C7 vertebral level, guided by anatomical landmarks such as the Chassignac’s tubercle, cricoid cartilage, and carotid artery.
  • During the procedure, the patient lies on their back with a rolled sheet between their shoulder blades, and the neck is cleansed with antiseptic.
  • The injection is administered using a small needle.
  • The local anesthetic takes 10 to 20 minutes to take full effect.


Expected temporary changes include drooping of the eyelid, a bloodshot eye, a stuffy nose, temperature increase on the injected side, and hoarseness. While these changes are typically short-lived, patients should be aware of potential risks such as seizure, pneumothorax, brachial plexus block, spinal or epidural block, allergic reactions, nerve damage, and bruising at the injection site.



To enhance precision and safety, physicians should use ultrasound guidance during SGB procedures. Patients should also inform their doctor if they have:

  • an active infection
  • uncontrolled cough
  • high blood pressure
  • are on blood thinners


These are contraindications.  Generally, SGB is seen as a low-risk procedure with substantial potential benefits for those suffering from long COVID.

Expert Opinions and Theories

Medical professionals and experts have explored various theories for why SGB may be effective in treating long COVID symptoms. According to Fischer et al., SGB could disrupt overactive processes within nerve-immune-inflammation feedback loops by modulating the autonomic nervous system. This modulation enables the self-regulation of these processes. This disruption helps to reset the autonomic nervous system, reducing the chronic sympathetic hyperactivity seen in long COVID patients.


Lipov et al. proposed another theory, suggesting that the therapeutic action of SGB might predominantly engage sympathetic block-mediated peripheral vasodilation, albeit the mechanism could be more complex. The timing of using SGB in managing long COVID syndrome may also be crucial. This is because the level of neuroadaptation that has taken place could impact the SGB’s effectiveness.

Future Directions and Further Research

To affirm the efficacy of SGB in treating long COVID symptoms, further research is indispensable. Double-blind placebo-controlled trials are crucial for validating the results and understanding the underlying therapeutic mechanisms and long-term effects of SGB. Additionally, research should focus on the role of ultrasound guidance, specific anesthesia, and the optimal timing of SGB to avoid diminished effectiveness due to neuroadaptive changes. Incorporating diagnostic and therapeutic strategies into these studies will help to ensure a comprehensive understanding of the treatment’s potential.


Further studies are also needed to determine the most effective local anesthetic for SGB in long COVID patients. Investigating gender differences in symptom presentation and resolution in response to SGB could provide valuable insights for personalized treatment strategies.

Advice for Patients and Physicians

Patients considering SGB for long COVID should be informed of the following:


  • The majority of patients experience symptom relief, with 86% of one study cohort reporting improvement.
  • Potential side effects include hoarseness and transient Horner’s syndrome.
  • Promptly reporting any adverse effects post-SGB is essential for timely management.


Administering SGB in a timely manner is vital as any delay could lead to neuroadaptive changes, reducing its effectiveness. Physicians should consider SGB as a potential adjunctive treatment modality for patients suffering from long COVID, especially those with persistent symptoms that have not responded to other treatments.

Conclusion & Where To Find Help

The Albany Clinic in Carbondale, Illinois, offers expert care and support for long COVID patients, providing SGB treatment. This clinic uses state-of-the-art ultrasound guidance to enhance precision and safety during the procedure. If you are local to Carbondale, seeking treatment at The Albany Clinic could be a promising step towards symptom relief and recovery.


Though the journey through long COVID can be daunting, the advent of emerging treatments like SGB brings hope for brighter days ahead. Engaging with knowledgeable healthcare providers and staying informed about the latest research can empower patients to make the best decisions for their health.


Summary

In summary, Stellate Ganglion Block (SGB) offers a promising treatment option for long COVID patients. By modulating the autonomic nervous system and influencing immune and inflammatory responses, SGB can significantly reduce symptoms like fatigue, brain fog, and muscle pain. The high success rates observed in studies provide a strong foundation for considering SGB as a breakthrough treatment.


As research continues to evolve, further studies will help refine the procedure and optimize its efficacy. For now, SGB stands as a beacon of hope for those struggling with the persistent and disabling symptoms of long COVID. Seeking expert care and staying informed are key steps towards recovery.


Frequently Asked Questions


What is Stellate Ganglion Block (SGB)?

Stellate Ganglion Block (SGB) is a procedure that entails injecting a local anesthetic into the stellate ganglion, which is a cluster of nerves in the neck. It is utilized to address sympathetically maintained pain, nerve injuries, and, more recently, long COVID symptoms.


How does SGB help with long COVID symptoms?

SGB can help with long COVID symptoms by modulating the autonomic nervous system, increasing blood flow to the brain, and regulating immune and inflammatory responses, which can alleviate symptoms such as fatigue, brain fog, and muscle pain.


What are the potential side effects of SGB?

The potential side effects of SGB include temporary changes such as drooping eyelid, bloodshot eye, stuffy nose, temperature increase on the injected side, and hoarseness, and more serious risks like seizure, pneumothorax, and nerve damage.


Who should consider SGB for long COVID?

Patients experiencing persistent long COVID symptoms that have not responded to other treatments should consider SGB after consulting with a healthcare provider to evaluate suitability and potential benefits.


Where can I receive SGB treatment for long COVID?

You can receive SGB treatment for long COVID at The Albany Clinic in Carbondale, Illinois, which provides expert care and support using state-of-the-art ultrasound guidance for enhanced precision and safety during the procedure.

35 Albany Rd. Suite A Carbondale, IL 62903

Phone:     (888) 804-4330

Cited Source(s):
  1. Liu, Luke D, and Deborah L Duricka. “Stellate ganglion block reduces symptoms of Long COVID: A case series.” Journal of neuroimmunology vol. 362 (2022): 577784. doi:10.1016/j.jneuroim.2021.577784
  2. Duricka D, Liu L. Reduction of long COVID symptoms after stellate ganglion block: A retrospective chart review study. Auton Neurosci. 2024 Aug;254:103195. doi: 10.1016/j.autneu.2024.103195. Epub 2024 Jun 13. PMID: 38901177.
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