If we suspect that your hand pain is related to a nerve-related injury or a condition called complex regional pain syndrome (CRPS), we can perform a safe injection called the Stellate Ganglion Block.
The stellate ganglion is a collection of nerves that lies in front of the cervical vertebra. These nerves function to affect blood flow to the arms and hands and this been found to play a role in certain pain conditions when there are nerve abnormalities.
During the injection, a needle is advanced with X-ray guidance to reach the stellate ganglion nerves at the C6 vertebrae. Special attention is placed to avoid the esophagus, trachea, and surrounding blood vessels. The local anesthetic medication is then deposited to block the collection of nerves.
After the injection, the affected hand should turn warm. This is often accompanied by a feeling of substantial pain relief. In addition, it is expected that all patients will experience Horner’s Syndrome. This is not a complication. Horner’s syndrome presents as drooping and tearing of the affected eye, constriction of the pupil, blurry vision, hoarse throat. This will return to normal after several hours when the local anesthetic medication wears off.
Many patients experience pain relief that lasts for days or even weeks. Some patients have pain relief that only lasts for several hours. This injection is helpful in helping diagnose the underlying CRPS or nerve condition. It also plays a role in managing pain flairs.