In cases of recent acute lesions of the upper extremity, stellate block affords relief from pain which is almost universally gratifying. These patients submit to, or even seek out, consecutive blocks. That the pain is probably vasospastic in origin is suggested by the fact that complete relief follows one or more blocks at frequent intervals. Clinical substantiation is evidenced by the results obtained in acute inflammatory and posttraumatic conditions, in which the major etiological factor is known to be circulatory impairment.
In chronic cases, in which the lesions have been present until such anatomical changes as adhesions, erosion of cartilage, or aberrant calcification supervened, it is obvious that only transitory relief from pain can be obtained. Adjunctive physical therapy should be employed in such cases. The range of physical therapy tolerated is in direct proportion to the relief of pain afforded by stellate block; and, in cases showing definite but transient improvement, it may be well to consider blocking with more noxious chemicals, such as alcohol derivatives; or even employing sympathectomy.