A Simple Non-Invasive Treatment for Multiple Common Conditions
A Simple Non-Invasive Treatment for Multiple Common Conditions
Stellate Ganglion Laser Therapy:
A Simple, Noninvasive Treatment for Multiple Common Conditions
By Ryan Novak, DC
Interventions at the location of the stellate ganglion are commonly used to inhibit the sympathetic nervous system and treat the pain of multiple etiologies, along with specifically treating neuralgias, headaches, PTSD, Ménière’s disease, Raynaud’s syndrome, scleroderma, and hyperhidrosis. Recently, researchers have been studying stellate ganglion interventions for angina, cardiac arrhythmias, and mental health conditions.
The most common practice in a healthcare setting is the stellate ganglion block, which is an invasive injection of medications that can have numerous side effects and serious rare complications, such as vascular, lung, tracheal and esophageal puncture, nerve damage, and injury to the thyroid gland. Noninvasive stellate ganglion laser therapy can produce very similar effects to the invasive injectable procedure without side effects and possible complications.
An older case study published in 1992 in the Japanese Journal of Anesthesiology reported that a 68-year-old female who suffered from burning pain in the right forward for 11 years was successfully treated with laser irradiation near the stellate ganglion and near the right carotid artery.1 In 1997, the department of anesthesia in the Hokkaido University Hospital in Sapporo, Japan, conducted a double-blind crossover placebo-controlled study to confirm the effectiveness of laser irradiation on the area near the stellate ganglion in patients with postherpetic neuralgia. The small study concluded that laser irradiation produces similar effects to a stellate ganglion block.
In a systemic review and meta-analysis of 21 experimental studies published in 2017 in the American Journal of Physical Medicine & Rehabilitation, authors concluded that using light irradiation effectively relieves pain of various etiologies along with successfully inhibiting the sympathetic nervous system.2
In an article published in 2019 in Respiratory Care, authors found stellate ganglion irradiation significantly alleviated dyspnea induced by an external inspiratory load in healthy adults.3
In another research article published in 2021 in the Journal of the American College of Cardiology, a study showed that stellate ganglion phototherapy reduced sympathetic activity and suggested it may be a safe, effective adjunctive therapy to control the electrical storm in some patients.4
How can this be easily implemented in clinical practice? Many of the research studies available treated the patients bilaterally while in a supine position and irradiated the stellate ganglion area for one to 10 minutes, depending on the particular laser and the amount of energy delivered in that study. The area of the stellate ganglion can be located on the anterior of the neck in the jugular groove, 2 to 3 cm above the costoclavicular joint and between the cricoid cartilage and anterior border of the sternocleidomastoid muscle.
Each patient and case are specific, so always make sure to do a thorough case history and diagnostic measures to assess the sympathetic nervous system of each patient to determine a proper treatment plan and clinical endpoint. From experience, as low as 1J/cm2 delivered bilaterally over the area of the stellate ganglion may be an effective treatment dosage for some patients, along with treating other relevant points for each particular case. Multiple laser treatments are usually needed, and some patients may need maintenance treatments once a month at home or in the office.
References
Ohtsuka H, Kemmotsu O, Dozaki S, Imai M. [Low Reactive-Level Laser Therapy Near the Stellate Ganglion for Postherpetic Facial Neuralgia]. Masui. 1992 Nov;41(11):1809-13. Japanese. PMID: 1334163.
Liao CD, Tsauo JY, Chen HC, Liou TH. Efficacy of Stellate Ganglion Blockade Applied with Light Irradiation: A Systemic Review and Meta-analysis. Am J Phys Med Rehabil. 2017 Jun;96(6):e97-e110. doi: 10.1097/PHM.0000000000000675. PMID: 28118275.
Izukura H, Kanezaki M, Ebihara S. Alleviation of Dyspnea Sensation by Phototherapy in Healthy Adults. Respir Care. 2019 Sep;64(9):1082-1087. doi: 10.4187/respcare.06496. Epub 2019 May 21. PMID: 31113856.
Nonoguchi NM, Adachi M, Nogami A, Komatsu Y, Sato T, Ueda A, Ogawa K, Togashi I, Miwa Y, Hoshida K, Momose Y, Shinoda Y, Kowase S, Nakamura K, Kaneko S, Soejima K. Stellate Ganglion Phototherapy Using Low-Level Laser: A Novel Rescue Therapy for Patients With Refractory Ventricular Arrhythmias. JACC Clin Electrophysiol. 2021 Oct;7(10):1297-1308. doi: 10.1016/j.jacep.2021.04.015. Epub 2021 Jun 30. PMID: 34217659.
About the Author
Dr. Novak is the chief scientific officer (CSO) for a photobiomodulation therapy device manufacturing firm, which has developed FDA-compliant devices such as the PainBusterSuper Pulsed Laser. He can be contacted at 877-799-7477 or via PainBusterPro.com.
