Recently, I have been responding to a lot of questions from headache sufferers on the internet and they all mention “neck injections”, so what exactly is “neck injections”? Can it really treat intractable headaches? Actually, the full name of “cervical injection” is “stellate ganglion block” (SGB). It is performed by applying local anesthetics to the stellate ganglion to achieve the appropriate clinical effect. This brings up another concept, what is “stellate ganglion”? The stellate ganglion is formed by the fusion of the 6th and 7th cervical ganglia and the 1st thoracic ganglion, and is located from the transverse process of the 7th cervical vertebra to the front of the 1st rib neck, above the long cervical muscle, surrounded by the pulmonary apex, common carotid artery, subclavian artery and vertebral artery. People may be put off as soon as they see the anatomy of the stellate ganglion. Wow! There are so many important organs around, what should we do if we accidentally hit the wrong place? In fact, for a trained pain physician, this treatment is just one of the routine operations that a resident must master, and the procedure is not complicated. The entire operation can be completed in less than 1 minute after the needle is inserted to reach the bone surface, and a course of treatment usually lasts 10-14 days. How is stellate ganglion block (SGB) used to treat cervicogenic headache? Cervicogenic headache is a common and frequent disease that affects human health. Cervicogenic headache is a group of syndromes with predominantly ipsilateral headache caused by organic or functional injury to the cervical-occipital or and shoulder tissues, often accompanied by cervical pressure pain and associated with cervical nerve stimulation. Vertebral artery cervical spondylosis is a common type of cervical spondylosis and is second only to neurogenic cervical spondylosis in its onset. SGB plays an indispensable role in the treatment of this type of disease, not only regulating the hypothalamus through central action to maintain the stability of the internal environment, thus keeping the body’s plant nervous function, endocrine function and immune function normal, but also making the sympathetic nerves in the distribution area normal through peripheral action. This method not only regulates the hypothalamus through the central action to maintain the stabilization function of the internal environment, so as to keep the phytoncotic, endocrine and immune functions of the body normal, but also causes the cardiovascular movement, glandular secretion, muscle tension, bronchial contraction and nociceptive conduction innervated by sympathetic nerve fibers in the distribution area to be inhibited through the peripheral action, which promotes the absorption of local inflammatory exudates and pain-causing substances, enhances tissue metabolism, and blocks the vicious cycle of pain, muscle tissue ischemia and pain, thus strengthening the effect of cervical paravertebral block treatment. Studies have shown that repeated SGB is a resurrection exercise for the vegetative nerves and can restore the disruption of sympathetic vagal balance caused by increased sympathetic activity. Blood norepinephrine (NE) is a sensitive indicator of sympathetic nerve activity. It was found that NE in serum decreased significantly after SGB in patients with pain, cancer, and menopausal syndrome, but it was still within the normal range; while NE concentration in plasma was changed after SGB in normal subjects, but the difference was not significant. At the same time, SGB can improve blood supply to tissues and organs, and improve abnormal blood rheological indicators, including reducing whole blood hyperviscosity and erythrocyte pressure volume to accelerate blood circulation. Furthermore, SGB increases cerebral blood flow more than any drug, and the increase in hypothalamic blood flow can play a role in maintaining pituitary hormone balance, thus regulating the abnormal changes in the endocrine system. In addition, it has been reported in the literature that cellular and humoral immune functions improve in patients with chronic diseases after SGB.