Pair a quick injection in the neck with an intense stretch of talk therapy, and PTSD symptoms can tumble fast. That is what researchers at The Ohio State University are reporting after testing a stellate ganglion block, a targeted nerve injection, alongside daily cognitive processing therapy in military members and veterans. Many participants saw their PTSD scores plunge within about two weeks, and the improvements stuck around for months.
Randomized Trial Finds Faster Relief With Nerve Block Plus Therapy
In an open-label randomized wait-list trial, the team enrolled 86 active-duty service members and veterans, then randomly assigned them to receive the nerve block either before or after a concentrated course of cognitive processing therapy. The peer-reviewed findings appear in Psychotherapy and Psychosomatics, and a university press release includes comments from senior author Jaryd Hiser, PhD. As reported by Cleveland.com, the trial has quickly caught the attention of both veteran advocates and PTSD researchers.
How The Study Was Conducted
The researchers tracked symptoms weekly using the PTSD Checklist for DSM-5 (PCL-5) so they could compare how quickly and how durably each group responded. Both groups improved over time, but those who received the stellate ganglion block before starting therapy reached clinically meaningful symptom reductions more quickly than those who got the injection after therapy. Full methods and statistical details are available on PubMed.
Results: Quick Drops And Lasting Gains
According to the press release from Ohio State Wexner Medical Center, average PCL-5 scores fell from about 50 to roughly 20 over an average span of two weeks. The team described that change as more than twice the standard improvement typically seen with therapy alone. Many participants kept those clinically meaningful gains at a one-year follow-up, suggesting that the benefit can last well beyond the initial treatment window. “The combination of SGB before daily CPT may be of particular interest to the Department of Defense for treating military personnel with PTSD,” Hiser said in the university release.
Where This Fits In The Evidence Base
Stellate ganglion block is not new in PTSD research. A 2020 multisite randomized trial in JAMA Psychiatry found that paired SGB treatments reduced symptom severity compared with a sham procedure, though the investigators cautioned that the relatively short follow-up and specific participant selection limited how broadly the results could be applied. Veterans Affairs reviewers and Department of Defense evidence summaries have continued to call for larger, longer multisite studies and clearer safety data before SGB is adopted widely across the VA system. The 2020 trial can be found on PubMed, and the VA evidence brief is available through the VA research office.
How SGB Works And Safety Considerations
Clinicians describe stellate ganglion block as an ultrasound-guided injection of a long-acting local anesthetic near the stellate ganglion, a cluster of nerves at the base of the neck that helps drive the body’s sympathetic “fight or flight” response. The goal is to dial down that overactive signaling, which can feed PTSD symptoms like hypervigilance and constant physiological arousal. The Cleveland Clinic outlines the procedure, typical side effects, and the recommendation to use image guidance to enhance safety. Systematic reviews report that serious complications are uncommon, while also stressing the need for experienced providers and careful patient screening.
Access, Next Steps, And What Veterans Should Know
For now, access is a patchwork. Many VA facilities offer stellate ganglion block only within research programs, while private clinics provide the procedure on a cash or insurance basis, so eligibility, appointment availability, and coverage can vary widely by location. Advocacy organizations such as the VFW have pushed for expanded research and more specialized centers to evaluate promising PTSD treatments like SGB. Follow-on trials, including an Ohio State registration listed on ClinicalTrials.gov, are examining implementation questions and which patients might benefit most. Researchers emphasize that the new Ohio State findings add momentum for larger multisite evaluations but do not replace established psychotherapies and medications as first-line care for PTSD.
