Stellate Injection

Treating eye and vision conditions

What is a Stellate Injection?
The injection blocks the Sympathetic Nerves. This may in turn reduce pain, swelling, color, and sweating changes in the upper extremity and may improve mobility. It is done as a part of the treatment of Reflex Sympathetic Dystrophy (RSD), Sympathetic Maintained Pain, Complex Regional Pain Syndrome, and Herpes Zoster (shingles) involving upper extremity or head and face.

The purpose of this injection is to calm down or “block” the hyperactivity of the sympathetic nerves. The goal is for partial or full pain relief after the injection. Relief
response may be delayed several hours or days. The long term goal is for reduction and elimination of pain, swelling and temperature change of the extremity as well as to increase dexterity.

What happens during the procedure?
You will be placed in the supine position (lying on your back) on the table in the fluoroscopy room. Your neck will be cleansed with an antiseptic solution and the area will be numbed. The doctor will use X-ray to guide the placement of a thin needle to the area of a group of nerves in your neck. After correct needle placement is confirmed by X-ray, a small amount of local anesthetic will be injected.

What should I do after the procedure?
A bandage will be applied to the injection site. You will return to the recovery area. A nurse will monitor your vital signs. You may experience any of the following immediately after the procedure and up to eight hours later: droopy eyelid, red or “bloodshot” eye, tearing, nasal stuffiness, hoarse voice, sensation of a “lump” in your throat, difficulty swallowing, sensation of warmth or tingling in your hand. These symptoms will disappear as the local anesthetic wears off. The nurse will ask you how much pain is relieved prior to discharge. Your discharge instructions will then be reviewed and you will be able to go home. You may be sent to physical therapy following the procedure.

General Pre/Post Instructions


You may eat a light, but not full meal at least one hour before the procedure, unless receiving intravenous sedation. If you are an insulin dependent diabetic do not alter your normal food intake.


Take your routine medications before the procedure (such as high blood pressure and diabetes medications) except for those that need to be discontinued five days before the procedure such as aspirin and all anti-inflammatory medications (e.g. Motrin/Ibuprofen, Aleve, Relafen, Daypro). These medicines may be re-started the day after the procedure. You may take your regular pain medicine as needed before/after the procedure. If you are taking Coumadin, Heparin, Lovenox, Plavix or Ticlid you must notify the office so that the timing of stopping these medications can be explained.


You must bring a driver with you. You may return to your current level of activities the next day including return to work.

Things that may Delay the Procedure

If you are on antibiotics please notify our office; we may delay the procedure. If you have an active infection or fever we will not do the procedure.