SGB for Long COVID: Can a Nerve Block Help Ease Symptoms?

What Is the Stellate Ganglion?

The stellate ganglion is a bundle of sympathetic nerves found on each side of the neck near the first rib. These nerves are part of the autonomic nervous system (ANS), which controls involuntary body functions like heart rate, blood pressure, and digestion.

The name "stellate" means "star-shaped" because this ganglion often appears star-like under a microscope. It plays a key role in regulating the body's stress response by controlling the release of norepinephrine, a chemical that activates the fight-or-flight response. 

When this system is overactive, it can lead to problems like inflammation, pain, and immune system dysregulation. However, SGB therapy can decrease activity at the stellate ganglion, downregulating fight-or-flight action and potentially restoring the harmful biological impact of stress. 

The Connection Between Long COVID and the Nervous System

Many scientists believe that Long COVID is partly caused by a disruption to the ANS. Normally, the ANS balances the sympathetic nervous system (which triggers the fight-or-flight response) and the parasympathetic nervous system (which calms the body down). 

However, in Long COVID, the sympathetic system appears to be overactive while the parasympathetic system is underactive. This imbalance is thought to cause overactivation of the immune system, leading to characteristic symptoms. 

Supporting this theory, people with Long COVID often show increased levels of inflammatory markers, such as:

• Cytokines like IL-6, TNF-α, IL-1β, IL-8, and IL-10
• C-reactive protein (CRP), a substance produced by the liver that rises when there is inflammation
  
  

How Does SGB Work?

SGB involves injecting a local anesthetic near the stellate ganglion, which temporarily blocks nerve signals. This may help reset the autonomic nervous system, shifting it away from a state of chronic stress and inflammation.

Here’s what happens during an SGB:

1. A doctor injects a numbing medication (like lidocaine or bupivacaine) near the stellate ganglion using a small needle.
2. The anesthetic temporarily stops nerve signals from being transmitted, which can reduce the overactive fight-or-flight response.
3. The procedure is done under ultrasound or X-ray guidance to ensure accuracy and safety.
4. Patients may feel immediate changes, such as warmth in the arm or relief from symptoms within minutes.
   
   

Scientific Evidence Supporting SGB for Long COVID

While SGB is not yet an approved treatment for Long COVID, some studies suggest it may be beneficial:

A 2023 study followed 41 Long COVID patients who received SGB. Most patients experienced symptom relief within 15 minutes of SGB, with improvements sustained for up to 1 year. The most common symptoms improved significantly, with 80% and 77% of those with brain fog and fatigue experiencing relief. 

A 2024 study investigated 27 long COVID patients who underwent SGB. Six patients were re-infected with COVID-19 or had negative responses to the vaccines, so their responses weren’t deemed valid. For those remaining, nearly half (10 patients) showed significant improvement in their symptoms, while nine experienced partial improvement. Only two patients did not respond to the treatment. Improvements were most prominent for symptoms associated with post-exertional malaise, which is when symptoms worsen after physical or mental activity.

How Does SGB Treat Long COVID?

Researchers believe SGB may help Long COVID patients by:

• Reducing inflammation – By calming an overactive sympathetic nervous system, SGB may lower levels of inflammatory cytokines.
• Restoring autonomic balance – SGB may help shift the body out of a prolonged fight-or-flight state, allowing the parasympathetic nervous system to function properly.
• Improving blood flow—The procedure can help relax blood vessels, improving blood circulation and oxygen balance.
• Modulating immune function – SGB may help regulate immune responses, preventing excessive inflammation that contributes to Long COVID symptoms.
  
  

Potential Risks and Considerations 

While SGB is generally considered safe, it does come with some risks, including:

• Temporary hoarseness or difficulty swallowing
• Minor bruising or pain at the injection site
• Rare complications like infection, nerve damage, or accidental injection into a blood vessel
  
  

Since SGB is not yet FDA-approved for Long COVID, it is considered an off-label treatment. Before pursuing this option, patients should consult with a healthcare provider to discuss the potential benefits and risks.

SGB Therapy at the Albany Clinic

If you're in Illinois and interested in the benefits of SGB, connect with our expert team at the Albany Clinic in Carbondale. As one of the few clinics offering this innovative therapy, we’re committed to providing a safe, comfortable experience tailored to your needs.