Stellate Ganglion Block and Long COVID: A Promising Path Toward Relief

Stellate ganglion block (SGB) is emerging as a safe, effective option for patients struggling with the lasting effects of Long COVID. By calming the body’s overactive stress response, this simple procedure is helping many regain energy, clarity, and quality of life.

TL;DR

• Long COVID (PCC) is a chronic condition present ≥3 months after infection, often involving autonomic nervous system imbalance [1–3]
• Stellate ganglion block (SGB) calms the body’s sympathetic nervous system and is being used to relieve Long COVID symptoms. Early studies and patient reports show encouraging improvements in fatigue, brain fog, palpitations, sleep, and mood [4–6]
• Safety: Performed with ultrasound guidance by experienced clinicians, SGB is generally very safe. Most effects are temporary, and serious risks are rare [7–9]
• Patient story: A Cleveland Clinic patient regained her sense of taste and smell after SGB, showing how powerful this treatment can be [10]

What is Long COVID?

Long COVID, or Post-COVID Conditions, is defined by the CDC as health issues that persist for at least three months after infection. Symptoms can affect many systems, including:

• Fatigue
• Brain fog and memory issues
• Palpitations and POTS-like symptoms
• Shortness of breath
• Sleep problems
• Loss or distortion of taste and smell

A key driver in many cases is dysautonomia — when the autonomic nervous system (which regulates heart rate, breathing, digestion, and stress response) becomes unbalanced. Patients often feel their “fight or flight” switch is stuck in overdrive, leaving their body exhausted and dysregulated [1,2].

What is Stellate Ganglion Block (SGB)?

SGB is an ultrasound-guided injection of a local anesthetic near the stellate ganglion, a bundle of nerves in the neck that helps control the sympathetic nervous system.

The procedure takes only minutes and is usually done in an outpatient setting. Patients often notice temporary signs like a droopy eyelid, mild hoarseness, or nasal stuffiness — all indicators the block is active. These fade within hours.

By calming the sympathetic nervous system, SGB gives the body a chance to reset and reduce the “fight-or-flight” response that fuels many Long COVID symptoms [7–9].

Why SGB May Help

Researchers propose several reasons why SGB works so well for some patients:

• Autonomic reset: Quieting sympathetic outflow helps restore balance between stress and rest systems [11]
• Immune modulation: The sympathetic nervous system interacts with immune organs. Blocking it may reduce inflammation linked to Long COVID [12,13]
• Improved circulation and sensory recovery: SGB may increase blood flow and help “reset” sensory pathways, explaining why some patients regain taste and smell [14]

Evidence So Far

Case Reports and Small Studies

• Liu & Duricka (2021): Patients experienced dramatic improvement in fatigue, brain fog, and dizziness after SGB [4]
• Kalava et al. (2023): Six patients with ongoing smell and taste issues improved after sequential SGB [15]

Larger Patient Groups

• Duricka & Liu (2024, chart review): Many patients had sustained improvements in fatigue, cognitive clarity, anxiety, and sleep at one month or longer [5]
• Chiang et al. (2025, 52 patients): Most reported meaningful relief, with side effects mild and short-lived [6]

Clinical Trials

• Farrell et al., JAMA Otolaryngology (2025): An RCT on parosmia (smell distortion) did not find SGB superior to placebo. While this shows it may not work for every symptom, many patients still benefit in other domains [16]

A Success Story: Cleveland Clinic

Jennifer, a patient at Cleveland Clinic, had suffered for months with loss of taste and smell due to Long COVID. After undergoing SGB, she experienced a dramatic restoration of her senses. For her, the block was life-changing — allowing her to once again enjoy meals and regain a part of her daily life that had been missing [10].

Effectiveness

Stellate ganglion block is showing very encouraging results in real patients. Improvements have been reported in:

• Energy levels
• Mental clarity
• Sleep quality
• Mood and anxiety
• Palpitations and dizziness
• Recovery of taste and smell

While ongoing studies will clarify exactly how and for whom it works best, the results so far are inspiring. Many patients feel like SGB has given them back pieces of their lives they thought were gone for good [5,6].

Safety

SGB is considered very safe when performed with ultrasound guidance by experienced doctors.

• Common temporary effects: Hoarseness, droopy eyelid, red/watery eye, nasal stuffiness — all fade within hours [7]
• Serious risks (rare): Vascular injury, pneumothorax, or nerve injury — minimized with expert technique and imaging [8,9]

This strong safety record, combined with the relief patients experience, makes SGB an increasingly appealing treatment option.

Who May Benefit Most

SGB is often considered for Long COVID patients with:

• Autonomic symptoms: racing heart, dizziness, fatigue, temperature swings
• Cognitive issues: brain fog, poor concentration
• Sleep problems
• Mood disturbances
• Persistent smell or taste loss

Doctors typically start with one side of the neck, then follow up with the other side if needed. Some patients improve after the first block, while others notice more change after both sides are treated. Relief can last weeks or months, and repeat blocks are sometimes offered [15].

Conclusion

Long COVID can be frustrating and overwhelming, but stellate ganglion block offers real hope. By calming the overactive stress pathways in the nervous system, SGB has already helped many patients regain energy, mental clarity, restful sleep, emotional balance, and even the return of taste and smell.

While research is ongoing, the growing number of success stories and the solid safety record make SGB a treatment worth asking about if you are living with Long COVID.

References

1. CDC. Clinical Overview of Long COVID. 2025.
2. CDC. Clinical Overview: Post-COVID Conditions (updated July 24, 2025).
3. NIH RECOVER Program. Autonomic dysfunction in Long COVID.
4. Liu & Duricka. Case series: SGB for Long COVID. 2021.
5. Duricka & Liu. Retrospective chart review of SGB for Long COVID. Autonomic Neuroscience. 2024.
6. Chiang et al. Retrospective cohort of 52 patients with Long COVID treated with SGB. Pain Physician. 2025.
7. Cleveland Clinic. Stellate Ganglion Block: Procedure and Side Effects.
8. SGB Complications and Safety Review.
9. Ultrasound-guided Stellate Ganglion Block Safety Data.
10. Cleveland Clinic. Patient success story: Pain injections restore taste and smell after Long COVID.
11. Stellate ganglion block in PTSD and autonomic reset mechanisms.
12. Review: Sympathetic regulation of immune function.
13. Hypotheses on neuroinflammation in Long COVID.
14. Hypothesis: Blood flow and sensory recovery after SGB.
15. Kalava et al. Six-patient series on smell/taste recovery after SGB. Cureus. 2023.
16. Farrell et al. Randomized clinical trial on SGB for COVID-related parosmia. JAMA Otolaryngology. Aug 14, 2025.