The expanding role of Stellate ganglion blocks (SGB) to Migraine treatment
If your not clear on what a stellate ganglion block is, click here. . Essentially, its an injection in the neck to calm the sympathetic nervous system. It also increases blood flow to the brain. We posted a video of the procedure – a ultrasond guided ijection into the sympathetic nervous system
If your one of the many migraine patients that don’t respond to conventional medications or botox injections, there may be an entirely new therapy available.
Up until recently, the effect of SGB on migraines was limited. Recently a number of studies were published offering hope.
A retrospective study examined the effects of SGB for the treatment of patients with chronic migraine in 97 patients. SGB was effective in reducing the pain intensity by 50% or greater in a very large percentage of patients. After an initial SGB block, patient’s response was charted at 1 month, 2 months, and 3 months. The response rate was that 90.7%, 82.5%, and 71.1% at month 1, 2 and 3 achieved a reduction in pain intensity of > 50% compared to pretreatment baseline. There were no serious complications; and any side effects like hoarseness of voice (the most common) was transient.
In 2022, another group published their observation study of 88 patients undergoing SGB once a week for 4 times. There was no control group in this study. At 3 months, their response was assessed by 1. MIDAS scale (Migraine Disability Assessment) questionnaire which is a short survey designed to quantify headache-related disability within 3months, 2. Numerical Rating Scale for most intense pain, and 3. Non steroidal pain medication use. The MIDA questionnaire asks five questions about work, housework and non-work activity (social, family and leisure activities) to assess the degree of disability caused by headaches.
At the end of 3 months, this study has a number of interesting results. All 3 outcomes showed improvement – MIDAS , NRS and NSAID use were all significantly improved after undergoing SGB.
What's the takeaway?
At Libertas Mind we typically use stellate ganglion blocks to treat PTSD, and the symptoms of Long COVID. The results of these studies suggest a SGB can reduce headache intensity and disability among migraine patients. More rigorous trials are needed. Because so many migraine sufferers struggle daily with their symptoms despite appropriate treatment, it seems reasonable to offer treatment resistant migraine patietns an SGB when other therapy hasn’t worked.
Choosing a provider with the right knowledge and skillset is key! We consider a stellate ganglion block a low risk procedure because of the training and expertise of our providers!
Ketamine is a transformative breakthrough treatment for patients suffering treatment resistant depression, PTSD, Anxiety, and more. Let the expert’s at Libertas guide your treatment.
