When My Body Wouldn’t Stand Down: How a Stellate Ganglion Block Helped My PTSD
There are parts of PTSD that live in your memories, and there are parts that seem to live in your body.
For me, some of the most difficult symptoms were not simply thoughts or memories. They were the physical manifestations of trauma—the constant state of alertness, tension, disturbed sleep, irritability, anxiety, and the feeling that my nervous system had forgotten how to stand down.
After my experiences as an Army Chaplain in Iraq, I eventually came to understand that PTSD was affecting me not only emotionally and spiritually, but physically as well.
One of the most helpful treatments I received for those physical, or somatic, symptoms was a procedure called a stellate ganglion block (SGB). I received the procedure at Landstuhl Army Hospital in Germany.
I also discuss this experience in my book, Refined by Fire.
What Is a Stellate Ganglion Block?
A stellate ganglion block is a medical procedure that involves temporarily blocking sympathetic nerve activity in the neck.
The stellate ganglion is a collection of nerve cells located near the base of the neck. These nerves are part of the sympathetic nervous system—the system involved in the body's "fight-or-flight" response.
During an SGB, a physician uses imaging guidance, such as ultrasound or X-ray/fluoroscopy, to carefully place a needle near the stellate ganglion. A local anesthetic is then injected around the nerve tissue. The goal is to temporarily interrupt sympathetic nerve signals. The procedure is generally performed by a trained physician, often in an anesthesia or pain-management setting. Because important structures are located in the neck, image guidance and appropriate medical monitoring are important.
For someone who has lived with PTSD, the concept can be particularly interesting: rather than trying to change a traumatic memory directly, the procedure temporarily addresses part of the body's overactive sympathetic response.
That distinction became very meaningful to me.
What the Procedure Was Like for Me
At Landstuhl, I underwent the procedure as part of my treatment.
I remember the experience not simply as a medical intervention, but as something that finally seemed to address the physical side of what I had been experiencing.
The treatment involved positioning me so that the physician could access the neck area where the stellate ganglion is located. Imaging was used to guide the procedure, and local anesthetic was injected near the nerve bundle.
It was a relatively focused procedure, but the significance for me was much greater than the time it took to perform.
What I experienced afterward was a change in the physical intensity of my symptoms.
For me, the stellate ganglion block was the most helpful treatment I received for the somatic symptoms of PTSD.
That is my experience—not a promise that the procedure will have the same effect on everyone.
When the Body Is Still Fighting the War
One of the things I have learned about PTSD is that the body can continue responding to danger long after the danger is gone.
You can know intellectually that you are safe and still have a nervous system that behaves as though the threat is present.
That can show up as:
Hypervigilance and being constantly "on guard"
Irritability or an exaggerated startle response
Difficulty sleeping
Physical tension
Anxiety and a racing sense of internal alarm
Difficulty concentrating
Feeling emotionally or physically unable to relax
Research into SGB for PTSD has particularly focused on symptoms associated with hyperarousal and the sympathetic nervous system. Some studies have reported meaningful improvement, while randomized trials have produced mixed results.
That mixed research is important to acknowledge.
The VA currently describes SGB as a possible treatment that may provide short-term benefit for some people with PTSD, but it does not consider it an established PTSD treatment because the evidence remains inconclusive. The VA continues to recommend established treatments such as trauma-focused psychotherapy and appropriate medications.
So I don't present my experience as proof that SGB is a cure for PTSD.
I present it as testimony.
It helped me.
The Science Behind the Treatment
The exact reason SGB may help PTSD is still being studied.
One theory is that temporarily reducing sympathetic nerve activity may help interrupt some of the physiological processes associated with chronic hyperarousal. Researchers have proposed connections involving the sympathetic nervous system and brain regions involved in fear and threat processing, although the precise mechanism remains incompletely understood.
That is one reason the treatment is so fascinating.
PTSD is often described primarily as a psychological injury, but the disorder involves the brain, the nervous system, emotions, behavior, sleep, and the body's response to perceived danger.
For some people, treating that physiological component may provide a window in which other forms of healing become more possible.
One military study found that two SGB treatments produced greater improvement in PTSD symptom scores than sham treatment over eight weeks. At the same time, another randomized controlled trial found no clinically meaningful difference between SGB and sham treatment.
In other words, the science is promising but not settled.
My experience, however, was very real.
What I Hope Others Take From My Story
I don't believe there is one treatment that works for everyone with PTSD.
What helped me may not help another veteran, service member, first responder, or trauma survivor.
And SGB should be considered a medical procedure—not something someone should attempt or pursue without qualified medical guidance. Serious complications are possible, even though studies and clinical programs have reported that the procedure can be well tolerated when performed appropriately.
What I do believe is that people suffering from PTSD deserve to know that there are different dimensions to the condition and that there may be different avenues toward healing.
For me, the stellate ganglion block was one such avenue.
But it helped quiet something in my body that had been screaming for far too long.
And sometimes, when you have spent years fighting an invisible war, having your body finally experience a little peace can be the beginning of something important.
That is why I wrote about this experience in Refined by Fire.
Because some wounds are invisible.
But invisible does not mean they aren't real.
And healing can begin when we are willing to acknowledge every part of the wound—mind, body, spirit, and soul.
Sources and Further Reading
Olmsted, K. R. L., et al. (2020). “Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial.” JAMA Psychiatry, 77(2), 130–138. The study involved active-duty service members and found greater improvement in PTSD symptom severity following two SGB treatments compared with sham treatment.
Hanling, S. R., et al. (2016). “Stellate Ganglion Block for the Treatment of Posttraumatic Stress Disorder: A Randomized, Double-Blind, Controlled Trial.” Regional Anesthesia and Pain Medicine, 41(4), 494–500. This earlier randomized trial found no significant difference between SGB and sham treatment.
Kerzner, J., et al. (2021). “Stellate Ganglion Block for Psychiatric Disorders: A Systematic Review of the Clinical Research Landscape.” Chronic Stress. The review found promising but mixed evidence for SGB in PTSD and emphasized the need for additional research.
Cheng, et al. (2025). “Stellate ganglion blockade for the treatment of post-traumatic stress disorder: A systematic review and meta-analysis.” The analysis found an overall reduction in PTSD symptom scores but noted that additional high-quality randomized trials are needed.
U.S. Department of Veterans Affairs, Evidence-Based Synthesis Program. “Effectiveness of Stellate Ganglion Block for Treatment of PTSD.” The VA evidence review summarizes the research and limitations surrounding SGB for PTSD.
U.S. Department of Veterans Affairs. “Stellate Ganglion Block Treatment for PTSD at VA.” The VA notes that SGB may provide short-term benefit for some individuals but is not considered an established PTSD treatment because evidence remains inconclusive.