Most Commonly Asked Questions about Stellate Ganglion Block (SGB)

Most Commonly Asked Questions about Stellate Ganglion Block (SGB)

If you've experienced symptoms of emotional trauma and mental health challenges, you've most likely researched the different types of treatments available for relief, like talk therapy and medication - two of the most common types of treatment. So naturally, we gravitate toward these treatments as they are currently the most well-known and covered by most insurance companies. 

We may be skeptical at first when we encounter new types of innovative treatments. While a whole network of innovative and minimally invasive procedures can offer relief sometimes in an instant, they aren't the first line of defense for treatment recommendations.

Innovative treatments like the Dual Sympathetic Reset (DSR), an advanced Stellate Ganglion Block (SGB), have been around for decades, even centuries, but many are just finding out about it now.

Stella's Dual Sympathetic Reset, has made waves in mental health care and has challenged the traditional care path model as a safe and efficient way to relieve symptoms like depression, anxiety, and PTSD. It can help relieve years, and even decades, of debilitating symptoms. As this life-saving treatment gains awareness, education is a crucial step in addressing the questions and concerns of those looking for the right care. 

This article covers the 15 most commonly asked questions about the Dual Sympathetic Reset (DSR):

Is SGB proven to work?

At Stella, we believe in the transparency of treatment outcomes. While no medical procedure is guaranteed to work for everyone, the Dual Sympathetic Reset (DSR) by Stella has helped thousands of patients find lasting relief from their trauma-related symptoms. 

The PTSD Checklist (PCL) is a self-report survey used to measure PTSD symptoms. According to the National Center for PTSD Guidance, a 10-point decrease in PCL score is a clinically significant improvement. In a study of 327 Stella patients who received SGB between December 2016 and February 2020, on average, over 83% reported a 28.9-point decrease in their PCL score. These Stella patients experienced a result that's almost three times better than that of other treatments.

How long do the positive effects of SGB last?

Over 83% of Stella patients experience lasting relief from their trauma symptoms after one dual injection of Stella's DSR protocol.

The duration of the Dual Sympathetic Reset's (DSR) positive effects varies from patient to patient, lasting months or years. 

While the longevity of DSR's effectiveness is still being researched, in a 2014 study, 70% of participants were clinical successes at a follow-up administered between 3 and 6 months after treatment.


Will DSR SGB erase my memory or impair my survival instinct?

The Dual Sympathetic Reset (DSR) does not erase your memory, but after treatment, you may find that your memory is clearer. 

DSR does not compromise your survival instinct because it does not "turn off" your fight-or-flight response. When your fight-or-flight response is stuck in an overactive state, your body is constantly experiencing a high level of stress which can be due to an imaginary threat. For example, it can feel like you're being chased by an imaginary bear, for example. DSR does not take your ability to run away from the bear. Instead, it removes the imaginary bear. Should a real bear appear, you will still instinctually run away from it. 


How is SGB by Stella different from SGB from other providers?

Widely considered the pioneer of the Dual Sympathetic Reset (DSR) for PTSD, Dr. Eugene Lipov, Stella's Chief Medical Officer, is a Board Certified anesthesiologist and pain management physician. Fifteen years ago, he discovered that SGB can "reset" the nervous system to its pre-trauma state, then expanding it to the Dual Sympathetic Reset.

SGB was originally developed as a single injection. 

After researching and testing many ways of administering SGB for PTSD treatment, Dr. Lipov found that two injections – known as the "Dual Sympathetic Reset" – yield the best results. The injections are given back to back. 

Each Stella doctor is Board Certified and is personally trained by Dr. Lipov in Stella's proprietary DSR methodology. We also require that our doctors use image guidance for correct needle placement.

Has SGB been clinically studied?

Yes, there are numerous clinical studies about Stellate Ganglion Block (SGB) and the Dual Sympathetic Reset (DSR).

This study explores the effectiveness of single and dual injection SGB. While both methods are effective, the study proposes that dual injection SGB, also known as DSR – the same approach Stella uses – may be more effective than a single injection SGB in the treatment of PTSD. 

Mulvaney S. W., Curtis K. E., Ibrahim T. S. (2020) Comparison C6 Stellate Ganglion versus C6 and C4 Cervical Sympathetic Chain Blocks for Treatment of Posttraumatic Stress Disorder (PTSD): Analysis of 147 Patients. J Neurol Disord Stroke 7(3): 1163.

This multisite, randomized clinical trial of SGB outcomes on PTSD symptoms, reports an improvement in the PTSD symptoms of active-duty service members after two SGB procedures. On average, the group treated with SGB experienced a 12.6-point decrease in their Clinician-Administered PTSD Scale (CAPS-5) score, and the control group experienced a 6.1-point decrease in their CAPS-5 score. 

Olmsted, K. L. R., Bartoszek, M., Mulvaney, S., McLean, B., Turabi, A., Young, R., … & Walters, B. B. (2020). Effect of stellate ganglion block treatment on posttraumatic stress disorder symptoms: a randomized clinical trial. JAMA psychiatry, 77(2), 130-138.

This review of recent and historical SGB literature finds evidence of substantial beneficial psychiatric effects that supports the use of SGB as a PTSD treatment that may provide positive results and reduce barriers to therapy, particularly among military populations.

Summers, M. R., & Nevin, R. L. (2017). Stellate ganglion block in the treatment of post?traumatic stress disorder: A review of historical and recent literature. Pain Practice, 17(4), 546-553.

Co-authored by Dr. Eugene Lipov, Stella's Chief Medical Officer, this study reviews the clinical evidence and neurobiology of SGB for PTSD treatment. 

Lipov, E., & Kelzenberg, B. (2012). Sympathetic system modulation to treat post-traumatic stress disorder (PTSD): a review of clinical evidence and neurobiology. Journal of affective disorders, 142(1-3), 1-5.

How does DSR work with other types of treatments (like talk therapy)?

The Dual Sympathetic Reset (DSR) can work well in combination with other treatments. After DSR, many Stella patients feel a new sense of calm that can accelerate the positive impact of existing therapies (e.g., talk therapy, EMDR, CBT, DBT, etc.). For example, patients may find that they can recall their past and discuss it with their mental health provider without feeling as though they're reliving it. 

If you already have a mental health provider, we suggest that you continue working with them after DSR to further your healing. If you do not have a mental health care provider, Stella may be able to refer you to one.

What's included with Treatment by Stella?

Treatment by Stella is a commitment to your recovery, from first contact to the moment you feel like yourself again. The Stella Standard of Care was created to meet your needs before, during, and after treatment. This is the new model of trauma treatment. 

Getting To Know You:

The first step is to speak with a licensed Advanced Practice Provider (APP). The APP will conduct a bio-psycho-social assessment, including a review of your symptoms and health history. The APP will create a custom treatment recommendation for you using this information.

Our APPs use validated measures to gauge your symptoms. These measures include the Post-traumatic Stress Disorder Checklist (PCL-5) for symptoms of PTSD/ emotional trauma, the Generalized Anxiety Disorder-7 (GAD-7) for anxiety, the Patient Health Questionnaire-9 (PHQ-9) for depression, and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) for traumatic brain injury.

Curated Care:

Throughout the journey, you will work with a dedicated Patient Care Coordinator who will coordinate your care and help answer any questions along the way.

If receiving the Dual Sympathetic Reset (DSR), the entire procedure takes less than 20 minutes, but please plan on being at the facility for one to two hours. The positive effects of DSR are often immediate.

If receiving ketamine, each treatment typically takes 45 minutes. Please plan on being at the facility for one to two hours. Most have relief from symptoms within hours of treatment.

Those on Care Plans will work with Stella's APPs over six months and receive an individualized treatment plan that combines biological and psychological interventions to provide the best outcomes possible.

Ongoing Support:

Following treatment, your APP will call to review the procedure's effectiveness and ask about any symptoms you may be experiencing. Each patient will also have a 30-minute follow-up to continue that review and discuss how to maximize the positive effects of treatment. APPs are there to physically, mentally, and emotionally support a patient, as uniquely required, during this session.

Those on Care Plans will have additional follow-up sessions with Stella's APPs, which include completing standard mental health assessments, determining whether additional treatment is warranted, and discussing trauma-informed, healing-related topics such as getting better sleep, approaching grief, or mindfulness techniques.

Stella is here for you

Fast and effective care for symptoms of emotional trauma and mental health challenges is at our front door, and we have already helped thousands of people in need. The more questions asked and the more information given can help lead innovative treatments like DSR and mental health companies like Stella into the lives of people in need. We're dedicated to you and innovative treatments because the possibilities are endless. 

If you are interested in learning more, please contact our Care Advocate team directly by calling 908-293-7559.

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