The stellate ganglion block (SGB) is a very common safe procedure that has been around for almost 100 years. It was developed back in the 1920's to treat chronic regional pain syndrome. It wasn't until much more recently (2007) that we started using it for the treatment of post traumatic stress. (We have also used it successfully for the treatment of hot flashes and opioid and alcohol addiction.) We treat civilian as well as military patients. Currently, about 60% of our patients are civilian, many of whom suffer from CPTSD (Complex PTSD.)
The SGB is a 'one visit treatment' that has the potential to offer months or even years of relief from your symptoms. If your symptoms do return, there is no determent to receiving the SGB again.
There are some common side effects we expect to see following SGB treatment. These are normal affects. You will experience a droopy blood shot right eye, stuffiness in the right side of the nose and a warm feeling in the right side of the face and right arm. These should last for about 6 – 8 hours. You may experience some difficulty swallowing or hoarseness of your voice. If these occur, they also could last for about 6 – 8 hours. Serious side effects are very rare thanks to the use of x-ray guidance for needle placement and IVP dye for verification of medication distribution.
FAQ:
1. Is this procedure covered by insurance.
Unfortunately at this time, we are not aware of any insurance covering the SGB when it is administered for the treatment of PTSD.
2. Are you connected with any other doctors or facilities around the country that are offering this procedure for PTSD.
We have no connections with any other doctors currently performing the SGB for PTSD. As it is not covered by insurance, you would need to find a doctor willing to perform it for a cash price.
3. If this procedure is so common and has been around for a long time, why is it so difficult to find a doctor to perform it for PTSD.
Because of the lack of insurance coverage, and the fact that it has not been used for long for treating PTSD, doctors not familiar with its usage may be unwilling or less willing to offer it for treatments other than covered diagnoses.
4. I don't know if I should stay awake or take the twilight sedation for the procedure. Is it very painful? How long does it take?
There is some pain associated with the procedure. Dr. Lipov will administer a local anesthetic at the injection site, whether you receive twilight sedation or not. You should be comfortable with needles and have some tolerance for a little pain if choosing to remain awake. This is for your comfort and for that of the doctor as it is important for you to remain still during the procedure. Additionally, if you experience too much discomfort during the first (C6) injection, Dr. Lipov may not be able to perform the second (C3) injection.
5. Is there a limit to how many times I can receive the injection? How long should I wait between visits? When will I know it is time for another injection?
There is no limit to the number of times you can receive the injection. There should be at least two weeks between visits. It is a personal decision as to if or when it is time to return for another procedure.
You will know how much relief you received. You may notice a return of some or all of your symptoms. If you ever feel like you are in need of another procedure, or would like to discuss your condition, you are always welcome to contact our office.
6. How soon after treatment can I resume my normal activities?
We recommend that you take it easy for 3 days following the procedure. This would include no visits to a chiropractor, massage therapist, no working out. If you have a physical job, you should have a few days to recover as well.
7. How long is the wait once I turn in my application to hear if I am approved? To schedule an appointment?
Usually we are able to respond within one week or less to let you know if we have any questions about your application, or if we are able to approve you for treatment. Currently, our wait for treatment is only a few weeks. This may change based on patient volume.
8. Do I need to make a trip to see Dr. Lipov for an evaluation before I can receive the treatment?
We do not need to see you prior to your visit to receive treatment. We obtain all pre-operative information prior to you making a trip to see us in the office. If we have questions about your application, need to obtain health records from one or more of your doctors, or need to clarify with you anything on your application, this will all be performed prior to you making a trip to see us.
9. Do I need to be a military veteran to get this treatment?
We treat military and civilian patients alike. We actually treat more civilians than military veterans. About 60% of our patients are civilian, many of whom suffer from CPTSD (complex PTSD.)