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Sphenopalatine Ganglion Block 

sphenopalatine ganglion block Texas

Cluster headaches and migraines can be crippling in their own right, but when it also leads to acute or chronic facial pain, it’s even that much worse. It can be hard to see, eat, and even think when all you can focus on is the pain you’re feeling in what feels like every part of your head and face. If this sounds like you, then a sphenopalatine ganglion block can finally help relieve your pain symptoms. The Texas Pain Care team in the Sugar Land, Missouri City and Houston areas can successfully utilize the sphenopalatine ganglion block to provide long-term relief with very few side effects.

What is a Sphenopalatine Ganglion Block?

A sphenopalatine ganglion block is a minimally-invasive procedure that is used to treat certain types of acute and chronic head and face pain. 

The sphenopalatine ganglion (SPG) is a bundle of nerves located below the nose, deep in the face. It is responsible for carrying sensory information, including pain signals, from the brain, as well as playing a role in tear production and nasal congestion. It is also linked to the sensory, parasympathetic and sympathetic nervous systems, which all transmit and receive pain signals. Most of the pain in the face, eyes and jar during a migraine can be linked to the sphenopalatine ganglion. 

In addition to the sphenopalatine ganglion itself, there are also nerves and fibers that pass through the ganglion. The trigeminal nerve is a major nerve involved in headache disorders. Additionally, the postganglionic parasympathetic fibers and the somatic sensory afferents are affected by the sphenopalatine ganglion. 

By performing a sphenopalatine ganglion block, all of these nerves and fibers that are sending pain signals can be blocked from doing so, providing a wide range of pain relief. 

What Conditions Can a Sphenopalatine Ganglion Block Treat?

The sphenopalatine ganglion block is used to treat a wide variety of headache disorders that lead to head and face pain, including: 

Migraine and cluster headache: a sphenopalatine ganglion block provides both quick and long-lasting relief from headache pain with very little (if any) side effects, as well as the possibility of being headache-free. Some providers might also combine the block with radiofrequency ablation, which offers patients even more long-term relief. 

Head and neck pain related to cancer: providing great relief to cancer patients and their families, sphenopalatine ganglion blocks that were delivered transnasally at home were able to effectively relieve cancer pain in the neck and head, even when other medications and opioids failed to do so.

Trigeminal neuralgia: a complex and painful headache condition that presents with pain on one side of the face, trigeminal neuralgia is historically difficult to treat, but the sphenopalatine ganglion block is able to provide patients with almost immediate and long-lasting relief.

While the sphenopalatine ganglion block is a great cure for face pain for a myriad of conditions, it is not the best option for all. Your pain management specialist will be able to determine if the block is right for you. 

Additional conditions that a sphenopalatine ganglion block proven helpful for treating face and head pain include:

The most common pain conditions treated with this procedure include:

  • Temporomandibular joint (TMJ) pain
  • Herpes zoster (shingles)
  • Sluder’s neuralgia (neurovascular headache)
  • Paroxysmal hemicrania (rare form of headache characterized by eye pain)
  • Atypical facial pain (unclassifiable pain syndromes in the face)
  • Complex regional pain syndrome (CRPS)
  • Reflex sympathetic dystrophy (RSD)
  • Vasomotor rhinitis (inflammation of the nasal tissues)
  • Pre- and post-operative anesthesia in oral and maxillofacial surgery 

What Does the Sphenopalatine Ganglion Block Procedure Involve?

A sphenopalatine ganglion block is a minimally-invasive and quick procedure that has been proven to provide immediate pain relief with minimal, if any, side effects. Due to the location of the sphenopalatine ganglion block, the medication can either be administered transnasally, transorally or laterally. Regardless of which option is used, the procedure will begin with the patient lying on their back. Sedation can be used if the patient is nervous or anxious. 

With the transnasally approach, the patient will extend the neck and open the nostrils as if taking a deep nasal inhale. The provider will ensure that the nasal passage is clear of any blockage (polyps, for instance) before having the patient inhale anesthetic medication to numb the area. If a topical application is used (versus an injection), the provider will introduce a cotton-tipped applicator with anesthetic that they will slowly move until it reaches the nasopharynx. The applicator will remain in place for 20 to 30 minutes. 

If the provider deems that more complete coverage is needed, or there is a blockage that makes reaching the nasopharynx unavailable, they will flood the nasal area.

If the provider opts for an injection, part of the cheek will be anesthetized before using X-ray guidance to insert a small needle into the desired location in the sphenopalatine ganglion. Once confirmed, the anesthetic is injected. Also known as the percutaneous infrazygomatic approach, this is a targeted way to deliver the block into a specific space. 

Patients can expect to recover immediately after the procedure. There might be a bitter taste in the mouth, but that’s normal, and it’s advised to wait to eat or drink anything until it wears off. All patients experience pain relief, but to what extent varies. Some are able to live pain-free for weeks, while others years. 

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What are the Benefits and Risks of the Sphenopalatine Ganglion Block?

The main benefit is immediate pain relief. Not only is this beneficial in general, it’s also beneficial for patients who might be experiencing face and head pain as a side effect from another painful medical condition, but haven’t found the relief they need to be able to enjoy any sort of ideal lifestyle. 

To elongate the pain relief, some providers might recommend radiofrequency ablation, which helps to provide more long-term pain management. 

There are very few risks with the sphenopalatine ganglion block, being that it is a minimally-invasive procedure that utilizes only anesthetic. The main risks are a temporary feeling of numbness or a bitter taste in the mouth, both of which wear off quickly. There is the possibility of scraping the inside of the nostril, but in the event that happens, the patient could expect just a minor nose bleed. With the injection option, there is a minor risk of infection, but also very low. It is important, however, to let the provider know if you have had any issue with anesthetic in the past. 

Finally, patients are able to find face and head pain relief with the sphenopalatine ganglion block. If you are tired of living in pain and would like more information, please schedule an appointment with the Texas Pain Care team in the Sugarland, Missouri City and Houston areas today. 

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