When I had my first Stellate Ganglion Block (SGB) in September 2020 I believed the literature that asserts the nerve block “resets the autonomic nervous system (ANS).” I was highly disappointed to find that reality is far more complex. While SGB can provide significant, sometimes immediate relief from symptoms of PTSD and other trauma-related conditions, the effects are often temporary, and the need for multiple injections, as I have experienced, shows that the term “reset” is a significant exaggeration.
Why Multiple SGBs Might Be Necessary
Temporary Relief: The relief provided by SGB can be temporary because it interrupts the sympathetic nervous system’s hyperactivity rather than permanently altering the underlying mechanisms that cause it. Over time, the nervous system may return to its previous state of hyperarousal, requiring additional SGBs to manage symptoms.
Variability in Response: Not all patients respond to SGB in the same way. Some may experience long-lasting effects, while others may find that the relief is short-lived. This variability can depend on individual factors such as the severity of the trauma, the duration of symptoms, and how the nervous system responds to the block.
Underlying Factors: SGB addresses the physiological symptoms of PTSD by calming the sympathetic nervous system, but it may not address the psychological and emotional aspects of trauma. Without addressing these through therapy or other means, the symptoms might return, leading to the need for repeated treatments.
Cumulative Stressors: New stressors or triggers can reactivate the trauma response, even after an SGB. The nervous system is dynamic, constantly adapting to new experiences, so ongoing or new stress might require additional interventions.
Neuroplasticity: The brain and nervous system are highly plastic, meaning they can change and adapt over time. However, this plasticity also means that without sustained interventions that promote long-term change, such as therapy or behavioral strategies, the effects of a single SGB might diminish, necessitating repeated treatments.
The term “reset” is misleading because it suggests a one-time fix, which is not the case for everyone. The procedure does seem to have the ability to “reboot” or interrupt survival patterns in the nervous system temporarily, but it might not establish a new, stable baseline for everyone. For some individuals, it may function more like a “circuit breaker” that needs to be flipped multiple times as symptoms recur.
An Integrative Approach
Given that SGB might not be a permanent solution, combining it with other treatments might offer a more sustainable approach. Integrative therapies that include psychosocial support, somatic therapies, and ongoing lifestyle adjustments could help reinforce the benefits of SGB and potentially reduce the need for repeated procedures.
My experience of needing 23 SGBs to assist with Complex PTSD recovery illustrates that the procedure does not provide a lasting “reset” of the autonomic nervous system. It’s a valuable and even life-saving tool, but we need a broader, more holistic and neuroscience-informed approach to managing PTSD and trauma-related conditions. Understanding this can help in setting realistic expectations and planning a comprehensive treatment strategy that supports long-term healing and resilience.
This post includes content generated by ChatGPT, a language model developed by OpenAI. The AI-generated content has been reviewed and edited for accuracy and relevance.
