Dual Sympathetic Block By HUDSON MIND

Introduction

The Dual Sympathetic Block (modified Stellate Ganglion Block)  is a transformative solution for people living with symptoms of chronic anxiety or Post-Traumatic Stress Disorder (PTSD). The Block was first used in 1926 to relieve chronic pain, but in 2006 psychiatrists and anesthesiologists unlocked new potential when they saw how quickly it relieved the physical symptoms of mental trauma.

This discovery, pioneered by Dr. Eugene Lipov, broke through the barriers of how we recognize and care for mental trauma. Since 2006, Sympathetic Block treatments have consistently delivered rapid alleviation from the physical stress symptoms that have ruled patients’ lives. 

Despite their potency, Sympathetic Block treatments still live in the shadows of more conventional care options, like exposure therapy, talk-therapy, and antidepressant medication. And while these treatments are effective for some, they can also present additional challenges, like side-effects and a lengthy duration of treatment, that ultimately leave many cases of PTSD unresolved. 

Dual Sympathetic Blocks are here to change that. By targeting the biological repercussions of PTSD, Dual Sympathetic Blocks have helped over 83% of patients break free from the weight of mental trauma.

A Closer Look at Mental Trauma

PTSD is misunderstood. For all its internet buzz, the condition is still chronically underappreciated. Part of the problem lies in defining trauma, or rather, our collective instinct to draw lines around what trauma is and isn’t. 

PTSD entered the psychological lexicon in 1980, after psychologists began correlating symptoms among Vietnam veterans. The notion of PTSD as a product of combat (and only combat) quickly took hold. 

Today, the condition is still largely associated with war. And while an alarming number of veterans do live with PTSD, the real boundaries of trauma—and what causes it—are significantly broader and more complex. 

In 1980 researchers relegated trauma as, “an extraordinary event outside the range of human experience,”— the unimaginable. Today the CDC defines trauma as an experience “marked by a sense of horror, helplessness, serious injury or the threat of serious injury or death.” 

Clinical perception has evolved over the past 40 years, but public perception of trauma is still playing catch-up. 

Research into the experience of trauma is still unfolding, but here are a few examples of what we know so far:

     – Prior to the COVID-19 pandemic, 1 in 11 adults struggled with PTSD at some point in their lives.

     – Between 30%-40% of direct victims of natural disasters experience PTSD.

     – PTSD is not always an immediate response—some don’t feel symptoms until years after a traumatic experience.

The ongoing exploration into the enduring and invisible injury of trauma is vital. The more people can understand just how expansive trauma is, the more likely they will be to recognize symptoms in themselves and seek assistance.

The Body’s Response to Trauma

 

Trauma lives in people’s bodies—and in some cases, it can hold a body hostage for years.

During a traumatic or threatening experience, the body automatically kicks into its fight-or-flight response as a means of survival. As soon as danger is perceived, the brain sends a SOS to the nervous system, triggering a burst of neuroendocrine signals  that can be life-saving. When danger dissipates, the sympathetic nervous system is meant to retreat down to neutral levels, but sometimes it remains in a fight-or-flight state of alarm and alters the body’s biological condition. 

The system remaining in sympathetic overdrive can activate nerve growth that hinders the brain’s ability to decipher danger, perpetuating an environment of constant fear and stress. 

This state of constant internal stress can manifest in many ways, including:

  • Disrupted sleep
  • Overwhelming panic
  • Fits of unprovoked anger
  • Difficulty concentrating
  • Hypervigilance
  • Overly sensitive startle response

These persistent, physical responses to a traumatic event can make daily life difficult, and in some cases, unmanageable.

Resetting the Nervous System with a Dual Sympathetic Block

 

Anesthesiologists and clinical researchers have found that one way to bring the nervous system back down from a heightened state is by administering anesthesia to a bundle of nerves called the Stellate Ganglion. This nerve cluster sits just above the collarbone and directly coordinates the nervous system’s fight-or-flight response.

Temporarily numbing the Stellate Ganglion gives the body’s sympathetic nervous system the chance to rest and reset at a more neutral level. This temporary respite can rapidly diminish the feelings of heightened anxiety and panic that linger in the bodies of people who have experienced mental trauma. 

During a 20-minute procedure, a board-certified anesthesiologist uses advanced ultrasound technology to precisely administer a local anesthetic into nerve bundles in the neck. Once admitted, the anesthetic temporarily shuts off the nerve bundle, keeping it from sending more distress signals. Our physicians may also utilize Pulsed Radiofrequency Ablations or other medications to further extend the effects of the block.

These blocks not only stop future nerve growth in the brain, but they also eliminate extra nerve fibers that may have already been created while the sympathetic nervous system was locked in fight-or-flight mode.

Learn more about the science of the Dual Sympathetic Block here.

Dual Sympathetic Block for Anxiety

Dual sympathetic blocks are not just adept at reducing the effects of PTSD, they also show promising results for mitigating chronic anxiety. 

Anxiety is increasingly prevalent in modern life; research suggests that since the onset of the COVID-19 pandemic, global anxiety rates have risen from 7.3% to 25%. 

Anxiety manifests in the body in numerous ways. And if common therapeutic approaches like talk-therapy, cognitive behavioral therapy, or SSRI medications do not provide relief, these symptoms can make managing relationships and daily life a constant battle. 

Common symptoms of anxiety include:

  • Fear of losing control
  • Fear of physical injury
  • Increased heart rate
  • Nervousness
  • Nausea

Dual Sympathetic Blocks can reset the nervous systems in patients with anxiety. This neutralizing effect makes it possible for patients to affect lasting behavioral change through talk and cognitive therapy. 

Learn more about the science of Dual Sympathetic Blocks for Anxiety here.

Dual Sympathetic Block for Long Covid

 

The psychological effects of COVID-19 will likely be researched for decades to come. But lasting physiological effects are already evident. More people are being kept from returning to their daily lives due to Long COVID symptoms. 

Clinical studies show that 87% of recovered individuals who were previously hospitalized for severe symptoms of COVID-19 experience at least one persisting symptom for over 60 days. Symptoms of Long COVID may include:

  • Difficulty breathing
  • Chronic fatigue
  • Difficulty concentrating
  • Persistent cough
  • Persistent chest pain
  • Joint or muscle pain
  • Insomnia

As of this point in time, many treatments for Long COVID respond directly to the individual’s specific symptoms. However, Dual Sympathetic Blocks have shown promising results when used to treat a range of Long COVID cases. 

Dual Sympathetic Blocks temporarily reset the body’s sympathetic nervous system, which also restores the balance in communication between the nervous system and immune system. This restored harmony can effectively reduce symptoms of Long COVID. 

Learn more about the science behind Dual Sympathetic Blocks for Long COVID symptoms here

What to Expect Throughout Dual-Sympathetic Block Treatment

 

Pre-Treatment Screener and Scheduling

Before treatment, you can schedule a Complimentary Education Screener with one of our Physicians Assistants. During this session you will cover your physical and mental health history, as well as any other types of care you might currently be receiving. 

Following the screener, our team will assess your background and symptoms to ensure that a Dual-Sympathetic Block is the right course of treatment for you. Once confirmed, they will reach out to schedule your appointment.  

 

Before Treatment

The day of your treatment you are welcome to arrive early and relax in our Welcome Lounge. Our space features soothing and meditative design details to promote peace and calm.

If you’re working with a psychiatrist or talk therapist it is a good idea to let them know about your upcoming treatment. Some patients even set personal intentions and expectations with their therapy providers prior to treatment. 



During Treatment

Many of our patients choose to stay awake for the injections and feel comfortable throughout the procedure. But you are welcome to request Twilight Sedation. 

 

After Treatment

The entire procedure lasts just under 20 minutes. Afterwards, you are welcome to relax and reflect in our Recovery Lounge. Some patients do report feeling some light reactions following the injections, including:

Heightened Emotions – Some patients experience an immediate emotional response, including an urge to cry. We offer space and privacy to let these emotions out and process them for as long as needed. 

Lightness – Immediately following treatment, some patients say they feel as though a heavy weight has been lifted off of their shoulders. 

Fatigue – Some patients report feeling more tired than usual, which is par for the course following most medical treatments. We encourage people to take the time out of the rest of their day to rest their minds and bodies. 

FAQs

Is a Dual Sympathetic Block the same as a Stellate Ganglion Block?

The Dual Sympathetic Block is an evolved version of the Stellate Ganglion Block. The Dual Sympathetic technique was developed by the Stella Center’s Dr. Eugene Lipov. As a Hudson Mind advisor, Dr. Lipov personally trained our Anesthesiologists in this technique. This technique has been proven to be more effective than the single-site technique utilized by most clinicians, most recently in a 2020 study.

How effective is Dual-Sympathetic Block treatment?

Good question. Here are the facts:

In a study of 327 patients who received treatment between December 2016 and February 2020, over 83% reported a 28.9-point decrease in their self-reported PTSD checklist score. 

These patients experienced a result that’s almost three times better than that of other treatments measured by the National Center for PTSD Guidance, which considers a 10-point decrease in a PTSD checklist score to be a clinically significant improvement.

How long can I expect to feel relief from symptoms of PTSD and anxiety?

Alleviation of symptoms following treatment are typically immediate within 24 hours, and last anywhere from several months to several years. Each person has a different response to these blocks, however studies demonstrate meaningful improvements up to 3-6 months after the procedure. We encourage you to continue therapy during this period of time. 

Does the Dual Sympathetic Block hurt?

The Block is administered as an injection, so you will feel it. If it makes you feel more comfortable, you can also request conscious sedation. Any pain really depends on your pain tolerance, but we do everything we can to make you feel as relaxed as possible throughout the experience.

Will I experience any side effects?

Following your Dual Sympathetic Block treatment, you will experience a temporary eye drooping and redness, congestion, and extra warmth in your face and arm. Don’t worry – these effects are expected and are a positive sign that the block is in the correct place. These symptoms typically last for 6-8 hours. 

Other side effects may include hoarseness and difficulty swallowing. These usually resolve within hours as well. Our team uses two different imaging techniques to ensure accurate placement.

Is the Dual Sympathetic Block compatible with my other mental health treatment? 

Yes! Dual Sympathetic Blocks work well in conjunction with other treatments, like talk therapy or many of our other Interventional Mental Health services. You may find that this treatment actually accelerates your progression in therapy, because the reset of your sympathetic nervous system encourages a new sense of calm. In a calm state, you may be able to recall past traumatic events without feeling as though you are reliving and without sparking a fear response. 

We also offer the Dual Sympathetic Block as part of our Mental BioReboot Program. Please click HERE to learn more. 

What if I still experience symptoms of PTSD and anxiety well after my treatment?

For inadequate responses or people with severe symptoms, our physicians may recommend that you come back in for an additional Dual Sympathetic Block. If you are advised to come in for follow-up, our physicians will inject the block in the sympathetic chain opposite of where you first received treatment. The sympathetic chain on the left side of the body carries different information from the sympathetic chain on the right—some people may respond better to one side versus the other. 

In a follow-up appointment, we may also use additional techniques like Pulsed Radiofrequency to further extend the relief from the block.

Will the Dual Sympathetic Block remove my “flight-or-fight” response in real-world situations?

The Block does not remove your “fight-or-flight” response, or stop you from being able to recognize danger. Rather, this treatment softens your instinct down to an appropriate level that is manageable instead of overactive. 

Do I need to see a mental health provider to receive treatment?

You should choose the best healing path for you. Although it is not required, we do recommend working with a talk therapist before and after your Dual Sympathetic Block procedure. The Block can alleviate the symptoms that may be making it difficult for you to talk about an experience without reliving it. We’re happy to share our network of mental health providers and submit a referral on your behalf.

Is the treatment covered by insurance?

At this time Dual Sympathetic Blocks are not covered by insurance for their use in treating symptoms of anxiety, depression, PTSD, or OCD. They are currently only covered as treatment options for pain management.

Do you offer financing plans?

The Dual Sympathetic Block treatment is currently only  available as a cash-pay. Our team will work with you to develop a financing plan if you have documented financial hardship. Our goal is to make this treatment accessible and affordable for all of those in need.