Can a Sphenopalatine Ganglion Block( SPG Block) Work For My Migraine Headaches?
Sphenopalatine ganglion blocks are a classic yet effective way to treat migraines, cluster headaches, facial pain, and also facial neuralgias, as well as cephalgia or dysautonomia. SPG blocks were first described in the early 1900s by applying numbing medications on cotton swabs to the back of the nose. Previously, needles were used to perform the technique. This evolved to modern times as physicians now inject numbing medications through an FDA approved soft specialized straw, called a catheter, via the nostrils under x-ray guidance. This method is effective yet is only minimally invasive.
Where is the sphenopalatine ganglion?
The sphenopalatine ganglion (SPG) is a bundle of nerves located behind the nose. It carries information about sensation, pain and is a component of the autonomic functions of tearing and nasal discharge and congestion. Blocking this nerve and also, if necessary, the trigeminal nerve can treat many headache disorders as these two nerves are often involved with headaches or other facial pains.
How does a sphenopalatine ganglion block help my migraines?
The mechanism of migraines is not fully understood yet it is thought that pain signals from the meninges, or the covering around the brain, send pain signals down to the trigeminal nerve and pass through the sphenopalatine ganglion. In patients who experience parasympathetic symptoms during migraines such as emeis, nausea, sweating and tears, the SPG is hypothesized to have a key role. Therefore a SPG block may help break the pain pathway that the SPG perpetuates, and then may terminate or prevent ongoing migraine headaches or other types of headache, pain or dysautonomia.
How is the sphenopalatine ganglion block procedure performed?
Your doctor may numb your nasal passages with numbing medication. This is done to give you more comfort during the procedure. Also a decongestant might be used if necessary.
You will lay on your back and the catheter will be gently placed into one nostril. Once the catheter is in the correct location, the numbing medication will be pushed through the syringe that is connected to the catheter, and then the catheter will be taken out. The procedure will be repeated on the other nostril. The total time will be 10 to 20 seconds. You will stay lying on your back for a few minutes to make sure the numbing medication can take effect. Once comfortable and stable, you can go home.
What are the side effects of the sphenopalatine ganglion block?
This procedure is considered safe because it is minimally invasive. There are no needles if the soft catheter technique is used. The numbing medication in the nostril may cause your throat to be numb for about a few hours. Nasal bleeding, pain, or infection has been reported but are very rare.
How long can a sphenopalatine ganglion block last?
A SPG block can provide a patient migraine relief typically from 1 month to 3 months. Of course, this range can vary patient to patient. SPG blocks can be repeated as often as needed to reduce migraines. Some studies have shown that if this procedure is done twice a week for 6 weeks, the severity and frequency of chronic migraine can be significantly reduced.
Will my insurance cover sphenopalatine ganglion blocks?
Most insurances will cover SPG blocks if you have been diagnosed with chronic migraine headaches. Our office will work with your insurance to get the necessary documentation needed if it is covered.
What are other treatments for migraines?
Other common treatments for migraines include acute and preventative medications and Botox injections of the facial muscles associated with migraines. Each patient responds differently to treatments and it may be necessary to try different ones before finding one that works for your migraines.
Please see our blog regarding Botox injections here :
Some patients are also interested in ketamine infusions for migraines, which is something our office also offers.
Other patients might find benefit from Low Dose Naltrexone (LDN) for migraines or other chronic painful conditions.
If you are interested in contacting us regarding a consultation regarding migraines for you or a loved one or have more questions regarding sphenopalatine ganglion blocks or other migraine treatments, including ketamine infusions or low dose naltrexone LDN, please call (425)998-7884. Our office is located in Bellevue Washington but we serve Seattle, Redmond, Kirkland, Issaquah, and surrounding pacific northwest areas.