SGB therapy for Tietze’s syndrome pain

Stellate Ganglion Block therapy–A Treatment for Tietze’s Syndrome

I recently came across an article in the Japanese Journal of Anesthesia called stellate ganglion block therapy for a patient with Tietze’s syndrome.” The article, which can be found here, describes a patient who had severe Tietze’s syndrome for more than six years. Her pain (on a scale from 1 to 10) was a full 10; anyone who has ever had Tietze’s syndrome knows that kind of pain. But after this specific kind of therapy, the woman’s pain diminished to 3 out of 10.

The researchers treated the 45-year old patient with SGB therapy. When the woman first arrived, she had the classic signs of Tietze’s syndrome–excrutiating pain radiating toward her left shoulder and swelling of one costal cartilage. The researchers performed an ultrasound and saw that the first costal cartilage was swollen (as shown in the following pictures).

Ultrasound Images of Tietze’s Syndrome

Image from the Journal of Anesthesia of Tietze's syndrome

The stellate ganglion is found at the 7th cervical vertebrae, just behind the first rib. Stellate ganglion blocks  (injections of local anesthetic) around this area has been shown in the past to help with the pain caused by other chronic diseases, such as complex regional pain syndrome. The stellate ganglion is also a site targeted in acupuncture to alleviate pain.

Image from Northwestern University

Series of Stellate Ganglion Blocks Reduce Tietze’s Syndrome pain

The researchers injected 5ml of mepivacaine (a local anesthetic) into the stellate ganglion, which reduced the Tietze’s syndrome pain for six hours. After the fifth injection (she received one per week), her pain had lessened to 3 out of 10, and she was able to sleep through the night. Stellate ganglion blocks are known to have this effect–the more you have of them, the longer the pain relief lasts.

Stellate ganglion block to treat Tietze’s syndrome is performed under local anasthesia and only takes a few minutes. Side effects are rare. A full description of stellate ganglion block, how it’s performed and what you should expect can be found here, at the Redding Anesthesia Associate website.

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