The Hidden Enemy Within

Sarah didn't understand why her body was failing her. At 48, she was experiencing unexplained chest pain, chronic fatigue and inflammation that wouldn't resolve, despite her best efforts to eat right and exercise. Her doctor ran the usual tests - blood pressure elevated, blood sugar creeping higher, inflammation markers through the roof. But what her doctor didn't immediately connect was that Sarah's decade of high-stress work, care-giving for aging parents and unprocessed trauma from her past weren't just affecting her mental health - they were literally rewriting her biology.

Sarah's story isn't unique. It's the story of millions of people whose bodies are aging faster than they should, whose hearts are struggling, and whose chronic pain has become a daily companion. And at the root of it all? An overactive sympathetic nervous system locked in perpetual "fight or flight" mode.

The Stress-Inflammation-Aging Connection: More Than Just Mental Health

Here's what most people don't realise: chronic stress isn't just psychological - it's a full-body biological catastrophe.

Research from Ohio State University reveals that approximately one in three American adults has metabolic syndrome, a cluster of conditions including high blood pressure, elevated blood sugar, excess belly fat and abnormal cholesterol levels, that dramatically increase the risk of heart disease, diabetes and stroke. But here's the shocking part: stress, through its propensity to drive up inflammation in the body, is directly linked to metabolic syndrome.

Think of it this way: when you experience chronic stress - whether from work pressure, financial strain, relationship conflict or unresolved trauma - your body doesn't distinguish between a tight deadline and a charging lion. It responds the same way, flooding your system with stress hormones like cortisol, adrenaline and norepinephrine. Over time, these physiological effects can lead to calcium build-up in the arteries, metabolic disease and heart disease.

The Numbers Tell a Devastating Story

Heart Disease: The connection between chronic stress and cardiovascular disease is undeniable. The association of heart disease with chronic stress, both in early life and adulthood, is approximately 40-60%.

Higher levels of stress hormones are associated with a 63% increased risk of cardiovascular disease compared to lower stress hormone levels.

The worldwide INTERHEART study found that work stress was consistently associated with increased risk of heart attack, with a "dose response" relationship - periodic stress conferring some risk (odds ratio 1.45) and permanent stress conferring higher risk (odds ratio 2.17).

Chronic Pain: In 2023, 24.3% of U.S. adults - nearly one in four - had chronic pain and 8.5% had high-impact chronic pain that frequently limited daily activities. The incidence of new chronic pain cases is 52.4 per 1,000 people per year - higher than diabetes, depression and even hypertension. This isn't coincidental - chronic pain and chronic stress feed each other in a vicious cycle, mediated by inflammation.

The Inflammation Highway: How Stress Speeds Up Aging

93% of American adults have sub-optimal metabolic health and stress-related inflammation has been implicated in ininsomnia, late-life depression, anxiety, cognitive decline and Alzheimer's Disease.

When your sympathetic nervous system is chronically activated, it triggers a cascade of inflammatory responses throughout your body. Aging is accompanied by a 2- to 4-fold increase in inflammatory mediators and chronic inflammatory processes are implicated in atherosclerosis, insulin resistance, diabetes and metabolic syndrome.

This is what researchers call "inflammaging" - the chronic, low-grade inflammation that accelerates cellular aging, damages mitochondria (your cellular power plants), shortens telomeres (the protective caps on your DNA) and pushes you toward age-related diseases decades before you should experience them.

As one researcher put it: "People thinkof stress as mental health, that it's all psychological. It is not. There are real physical effects to having chronic stress" - including inflammation,metabolic syndrome, accelerated aging and a host of chronic diseases.

The Root of the Problem: Your Sympathetic Nervous System Stuck in Overdrive

Your autonomic nervous system has two main branches:

1. The  Sympathetic Nervous System ("fight or flight"): Increases heart rate, blood pressure, stress hormones and inflammation. Essential for short-term survival, but devastating when chronically activated.
2. The  Parasympathetic Nervous System ("rest and digest"): Promotes healing, digestion, recovery and calm. This is where your body should spend most of its time.

In chronic stress, trauma and persistent pain conditions, the sympathetic nervous system becomes hyperactive - the accelerator is stuck and the brake (parasympathetic system) is weak or broken. Your body interprets every day as an emergency, pumping out stress hormones continuously, constricting blood vessels, driving inflammation and accelerating metabolic dysfunction.

A Novel Solution: The Stellate Ganglion Block (SGB)

Here's where the story gets interesting - and hopeful.

For decades, pain specialists and anaesthesiologists have known about a procedure called the Stellate Ganglion Block (SGB) - a precise injection of local anaesthetic into a nerve cluster in your neck called the stellate ganglion. This nerve bundle is a major hub for sympathetic nervous system signals to your head, neck, arms and upper chest.

What Makes SGB Different?

Traditional approaches to managing chronic stress, inflammation and pain focus on lifestyle changes, medications and talk therapy - all valuable, but sometimes insufficient when the nervous system is locked in a chronic stress state. SGB takes a different approach: it physically interrupts the overactive sympathetic signaling, essentially giving your nervous system a chance to "reboot."

Research demonstrates that SGB significantly reduces elevated levels of stress hormones including CRF, ACTH, cortisol, norepinephrine and adrenaline, which are chronically elevated in stress-related conditions. After SGB treatment, the decrease in cortisol helps attenuate damage to brain structures like the hippocampus, supporting both emotional regulation and cognitive function.

The Evidence is Compelling

Originally used for complex regional pain syndrome (CRPS) and circulation disorders, researchers have been studying stellate ganglion blocks for post-traumatic stress disorder (PTSD) since 1990 and the applications continue to expand.

Animal studies show that SGB can attenuate chronic stress-induced depression by maintaining the stability of the autonomic system and affecting the hypothalamic-pituitary-adrenal axis - the body's central stress response system.

A large multi-centre, randomised controlled trial published in JAMA Psychiatry demonstrated twice the effect of SGB over a sham procedure for PTSD symptoms, providing "gold standard" Level 1 evidence.

The procedure has shown promise for:

• Post-traumatic stress disorder (PTSD)
• Chronic pain syndroms
• Complex regional pain syndrome (CRPS)
• Long COVID symptoms
• Chronic anxiety and depression
• Autonomic nervous system dysfunction

How Does It Work?

The proposed mechanism is that SGB decreases nerve growth factor levels, thus reducing norepinephrine and the hyper-aroused state of the sympathetic nervous system. By temporarily blocking sympathetic outflow, the procedure appears to help "reset" the autonomic nervous system, allowing the parasympathetic system to reestablish balance.

The procedure itself is:

• Quick: Takes about 20-30 minutes
• Safe: Performed under ultrasound guidance for precision
• Outpatient option as well as inpatient: Patients typically return to normal activities the same day
• Long-lasting: Many patients experience benefits that extend well beyond the temporary nerve block

Your Body Wants to Heal

Here's the truth that gives me hope as a physician: your body has an incredible capacity for healing when given the right conditions. When the sympathetic nervous system is calmed, inflammation can decrease, blood flow can improve, stress hormones can normalize, and metabolic dysfunction can begin to reverse.

Just as we can get into better physical shape, we can improve our metabolic health - but sometimes we need to address the underlying driver: chronic sympathetic nervous system dysregulation.

Is SGB Right for You?

If you're experiencing:

• Chronic pain that hasn't responded to conventional treatments
• Persistent inflammation despite healthy lifestyle choices
• Signs of metabolic syndrome with a history of chronic stress or trauma
• Symptoms of PTSD, anxiety or depression alongside physical symptoms
• Accelerated aging or chronic fatigue

...then it may be time to consider whether sympathetic nervous system dysfunction is at the root of your symptoms.

The Path Forward

The science is clear: chronic stress isn't just "in your head" - it's in your heart, your hormones, your immune system and your cells. It's driving inflammation, accelerating aging, and stealing years from your life. But emerging treatments like the stellate ganglion block offer a way to interrupt this cycle at its source.

Your nervous system has been trying to protect you, but sometimes it needs help finding its way back to balance. Sometimes it needs a reset.

If you're tired of managing symptoms without addressing the root cause, if you're ready to explore innovative approaches that target the sympathetic nervous system directly, reach out to discuss whether SGB might be part of your healing journey.

Your body remembers every stress, every trauma, every fear - but it also remembers how to heal.

Disclaimer: This blog post is for informational purposes only and should not replace professional medical advice. Stellate ganglion block should only be performed by trained stella physicians. Book a consult with us to determine if this treatment is appropriate for your specific situation.