The Stellate Ganglion Block is also called the Dual Sympathetic Reset (DSR). It is a science-backed, rapid technique that may relieve symptoms of PTSD, long COVID, dysautonomia, and chronic pain. Clarus Health is San Francisco's most experienced SGB center.
Learn the difference between SGB for PTSD and long COVID.
Stellate Ganglion Block · San Francisco
Reset your nervous system. Relief within 72 hours.
The SGB quiets a fight-or-flight response locked in overdrive — for PTSD, Long COVID, dysautonomia, POTS, and anxiety. Performed by board-certified anesthesiologists at Clarus Health.
Three intentional steps — each designed around your history, your nervous system, and your healing.
1
Step One
Holistic Intake
We begin by truly listening. Your provider reviews your complete picture — trauma history, nervous system symptoms, current medications, and goals — to confirm whether SGB is the right fit and build a protocol around your specific needs.
A precise, ultrasound-guided injection targets the stellate ganglion — a nerve cluster in the neck that regulates the fight-or-flight response. By resetting overactive stress signaling, SGB can deliver rapid, lasting relief from PTSD, anxiety, and trauma-related symptoms.
Many patients notice a meaningful shift within hours. We support your recovery with follow-up care, complementary therapies, and ongoing optimization — so the calm and clarity you've found has the best conditions to last.
Relief Within 24 HoursResults Last Months to YearsNo Downtime
Begin your journey today
How the Stellate Ganglion Block Works
The Problem
Trauma and chronic stress hyperactivate the Stellate Ganglion, locking the brain into a persistent fight-or-flight state — dysregulating the amygdala, insula, and hippocampus.
The Treatment
A precise injection temporarily numbs the Stellate Ganglion, cutting the flood of stress hormones (norepinephrine) and allowing the overactivated limbic system to finally relax and reset — often within hours to days of a single treatment.
The Healing
As the limbic system rapidly quiets, the brain rewires itself through neuroplasticity — a process powerfully amplified when paired with IV Ketamine for lasting relief from anxiety, hypervigilance, and PTSD.
Stellate Ganglion
Stellate Ganglion Block FAQ
What Is the Stellate Ganglion Block (SGB) in San Francisco?
At Clarus Health's stellate ganglion block clinic in San Francisco, the SGB is a 100-year-old, minimally invasive procedure where local anesthetic is injected around the stellate ganglion — the bundle of nerves in your neck that controls your fight-or-flight response. By temporarily blocking these nerves, an SGB can reset trigger–response pathways, reduce pain signals, lower inflammation, and restore balance to the autonomic nervous system. We serve patients throughout the San Francisco Bay Area, including those seeking stellate ganglion block treatment for PTSD, anxiety, dysautonomia, POTS, and Long COVID.
By quieting the fight-or-flight response, the Stellate Ganglion Block can reduce intrusive thoughts, flashbacks, hyperarousal, and many other symptoms of an overactive sympathetic nervous system.
What Is the Dual Sympathetic Reset (DSR) — and How Is It Different from SGB?
The Dual Sympathetic Reset (DSR) is Clarus Health's preferred advanced stellate ganglion block technique for mental health conditions. It involves two injections along the nerve bundle: one at the 4th cervical level and one at the 6th cervical level. This dual approach can lead to significant improvements in mood and energy.
What Conditions Can the Stellate Ganglion Block Treat?
The SGB and DSR can be effective across a range of conditions driven by an overactive sympathetic nervous system:
Insomnia and sleep disturbances — By calming sympathetic overactivation, SGB can improve both sleep onset and sleep quality. Recent research shows SGB combined with cognitive behavioral therapy for insomnia (CBT-I) produces significantly better and more durable results than either treatment alone.
Free 15-minute call · No obligation · Board-certified anesthesiologists
Stanford & Harvard trained
1,000+ blocks performed
Ultrasound-guided precision
How Does the Stellate Ganglion Block Procedure Work?
The SGB is a brief procedure — the injection itself takes approximately 15 minutes. The full appointment lasts about 90 minutes to allow for preparation and post-procedure monitoring.
PreparationYou lie down comfortably. The skin on the side of your neck is cleaned and numbed with a topical anesthetic.
Optional sedationAbout half of patients request light IV sedation for comfort. This is entirely optional. If you choose sedation, you will need a driver for the rest of the day.
Ultrasound guidanceDr. Kaveh uses real-time ultrasound to precisely visualize the stellate ganglion and surrounding structures — ensuring accurate, safe needle placement.
InjectionA small needle delivers local anesthetic around the stellate ganglion. There is no hallucinogenic medication used in this procedure.
MonitoringYou are monitored for 60 minutes after the injection so the care team can observe your response and address any side effects promptly.
SGB + NAD+ + IV Ketamine: A Triple Protocol for Long COVID and ME/CFS
Long COVID affects up to 10% of COVID survivors, and its most debilitating symptoms — fatigue, brain fog, dysautonomia, and POTS — overlap significantly with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Both conditions are driven by the same vicious cycle: a dysregulated nervous system triggering chronic neuroinflammation, which in turn perpetuates nervous system dysfunction.
No single treatment breaks this cycle completely. That's why Clarus Health uses a synergistic three-therapy protocol — stellate ganglion block, NAD+, and IV ketamine — each targeting a different layer of the problem.
What Each Therapy Contributes
Stellate Ganglion Block addresses the nervous system directly. By resetting the overactive sympathetic nervous system, SGB breaks the neuro-inflammatory cycle at its root — calming the fight-or-flight loop that keeps the immune system in a state of chronic activation. In Long COVID patients, over 75% report fatigue improvement and 80% report reduced brain fog following SGB.
NAD+ addresses the cellular energy crisis. SARS-CoV-2 infection depletes NAD+ levels throughout the body — reducing the function of SIRT1, a critical enzyme regulating immune balance and cellular repair. IV NAD+ supplementation directly replenishes these depleted stores, reducing fatigue and cognitive impairment in ME/CFS patients, and has been shown to be well tolerated in Long COVID. Because the brain is one of the highest energy-demand organs in the body, NAD+ restoration is particularly effective for brain fog and cognitive impairment.
IV Ketamine addresses the neuroinflammation and mood dysfunction that compound fatigue. Long COVID triggers reactive gliosis — a form of neuroinflammation that causes depression and makes it progressively harder to treat. IV ketamine has direct anti-inflammatory properties, reducing the specific cytokines that drive this cycle, while simultaneously promoting neuroplasticity to help the brain rebuild healthier patterns. It is a powerful option for depression and cognitive symptoms arising from Long COVID.
Why the Combination Is More Powerful Than Any Single Therapy
SGB resets the nervous system and reduces the inflammatory drive. NAD+ restores the cellular energy needed for recovery. IV Ketamine resolves the neuroinflammatory depression and promotes the neuroplasticity that makes gains last. Together, they attack Long COVID and ME/CFS from three angles simultaneously — something no single medication or procedure can replicate.
This may be because both SGB and IV Ketamine support neuroplasticity, providing the potential for "resetting" neural pathways for extended periods of time.
Stellate Ganglion Block Success Rate and Duration of Relief
Symptom improvement can last anywhere from several weeks to several years — on average, 2–3 months from a single procedure. Duration depends on many individual factors, especially how the nervous system responds and resets in the weeks immediately following the block.
Research suggests that combining cognitive behavioral therapy (CBT) with SGB produces better long-term outcomes than SGB alone — the window of nervous system flexibility created by the block is an ideal time for psychological rewiring.
Certain temporary effects confirm the stellate ganglion was properly numbed. These are expected and reflect the opposite of the fight-or-flight state:
✓ Expected success indicators
Horner's syndrome — droopy eyelid and constricted pupil
Arm warmth — blood vessel relaxation in the arm
Nasal congestion — blood vessel relaxation in the face
Eye redness — blood vessel relaxation in the eye
These effects are temporary and resolve within a few hours. They indicate a successful block. Dr. Kaveh will review all expected and rare side effects with you before the procedure so you feel fully prepared.
Stellate Ganglion Block in San Francisco — Start Your Healing Journey
The decision to pursue stellate ganglion block treatment depends on many factors, including the holistic benefits of treating your mental health, nervous system, and underlying root causes. You deserve to understand your options fully. Always speak with your doctor about the risks and benefits of SGB before proceeding. We are happy to discuss stellate ganglion block cost and insurance options during your consultation. Contact Clarus Health's San Francisco stellate ganglion block clinic for a free 15-minute consultation with Dr. Kaveh or Dr. Shrestha. We serve patients throughout the San Francisco Bay Area and welcome those searching for stellate ganglion block near me.
Live Stellate Ganglion Block (SGB)
Watch Alireza's live Stellate Ganglion Block (SGB) experience with Clarus Health
Meet Our Doctors
Drs. Anthony Kaveh is certified through the Bioidentical Hormone Replacement Academy. He is a Stanford and Harvard-trained physician who has guided hundreds of patients in restoring their inner healing capacity to rediscover meaning and purpose as part of their holistic healing journey.
What is the Stellate Ganglion Block?
Dr. Kaveh explains the Stellate Ganglion Block's potential for relieving PTSD, long COVID, anxiety, irritability, hot flashes, and chronic pain.
Health is more than simply the absence of disease
The Stellate Ganglion Block (or Dual Sympathetic Reset) can restore meaning, purpose, and fulfillment to provide sustained symptom relief
