Sphenopalatine Ganglion Block for Facial Pain: Exploring This Nerve Block for Chronic Headaches

If you or a loved one suffer from persistent facial pain or chronic headaches, you know how these conditions can profoundly disrupt daily life. The ongoing discomfort can impact your ability to work, socialize, and enjoy routine activities. Many people try various treatments—from medications and lifestyle changes to invasive procedures—often without lasting relief. However, there is a minimally invasive technique called the sphenopalatine ganglion (SPG) block that may offer new hope—especially for those struggling with certain types of facial pain and headaches. This innovative approach has been gaining recognition for its effectiveness and safety. Let’s explore how it works, who may benefit, and what to expect if you consider it as part of your pain management plan.

What is the Sphenopalatine Ganglion (SPG)?

Anatomy and Function of the SPG

The sphenopalatine ganglion, or SPG, is a small but important cluster of nerve cells located deep in the face, just behind the nose. Think of the SPG as a busy communication hub for nerve signals, particularly those related to pain and autonomic (involuntary) functions in the head and face. Although tiny—about the size of a grain of rice—this cluster plays a key role in how pain signals are transmitted and perceived.

The SPG connects to several important nerves that regulate sensation around the eyes, nose, mouth, and temples. It also influences certain automatic functions such as blood flow and tear production. Because of this central location, the SPG is involved in symptoms seen in disorders like cluster headaches, migraines with facial symptoms, and trigeminal neuralgia.

Why Target the SPG for Pain Relief?

Since the SPG serves as a central nerve hub transmitting pain signals, blocking its activity can reduce or interrupt the signals responsible for facial and head pain. Imagine turning down the volume on a loud radio; similarly, an SPG block “turns down” the pain signals.

Clinicians have found that targeting the SPG with a local anesthetic can provide rapid and meaningful relief, particularly in cases where standard treatments fail or cause intolerable side effects. Thus, the SPG block is a valuable adjunctive option in managing refractory (hard-to-treat) facial pain syndromes.

Understanding Facial Pain and Headache Symptoms

Common Symptoms Addressed by the Sphenopalatine Block

Patients who respond well to SPG blocks often describe pain characteristics that suggest involvement of this nerve cluster. These symptoms may include:

 
• Sharp, stabbing, or throbbing pain localized to one side of the face
 
• Sudden flares or cyclical bouts of intense pain typical of cluster headaches
 
• Electric shock–like jolts, especially in the cheek or upper jaw area, characteristic of trigeminal neuralgia
 
• Migraines with facial discomfort, nasal congestion, or pressure that mimic sinus symptoms

For example, one patient described their pain as “like lightning striking my cheek, followed by a deep, pounding ache behind the eye—nothing relieved it until I tried the SPG block.” Such vivid accounts help guide diagnosis and treatment approaches.

Diagnosing the Cause of Facial Pain

Before an SPG block is considered, healthcare providers perform a thorough evaluation to exclude other causes and confirm the appropriateness of the treatment. This assessment usually includes:

 
• A detailed medical and pain history, focusing on onset, triggers, duration, and quality of pain
 
• A physical examination with attention to neurological and nasal structures
 
• Imaging studies such as MRI or CT scans, if indicated, to rule out tumors, infections, or structural abnormalities

Correctly identifying the pain pattern enables clinicians to decide if an SPG block is suitable. For instance, episodic one-sided pain with autonomic symptoms like tearing or nasal congestion often indicates cluster headaches, while brief electric-shock sensations suggest trigeminal neuralgia.

Causes of Facial Pain Treated by SPG Block

Cluster Headaches

Cluster headaches are sometimes called “suicide headaches” due to their severity. They typically involve piercing, one-sided facial pain with tearing, nasal congestion, and sweating. Attacks occur in clusters, meaning multiple episodes over weeks or months.

An SPG block can quickly disrupt this painful cycle. Studies have reported that patients receiving SPG blocks during cluster periods often experience relief within minutes and may see reduced frequency and severity over time.¹

Trigeminal Neuralgia (Second Division – V2)

Trigeminal neuralgia is a nerve disorder causing sudden, severe electric shock-like pain in the distribution of the trigeminal nerve. The second division (V2) affects the cheek, upper lip, and upper jaw. When first-line medications such as carbamazepine fail or cause intolerable side effects, SPG blocks targeting the ganglion that influences this nerve area may offer substantial short-term pain relief.

Patients commonly describe the pain as “like being hit by a bolt of electricity,” making activities like chewing or talking difficult. SPG blocks can interrupt nerve irritation quickly, providing valuable symptom relief.

Migraines with Facial Symptoms

Many people are unaware that migraines can extend beyond head pain. Approximately 50% of migraine patients report associated facial pain, sinus pressure, or nasal congestion.² These symptoms can be confusing and may lead to unnecessary sinus treatments.

SPG blocks may help by interrupting pain pathways and autonomic responses causing facial symptoms, often improving both headache and facial pain.

Postoperative Facial Pain

Following nasal or sinus surgery, some patients experience significant facial pain that can delay recovery and reduce quality of life. SPG blocks, by numbing involved nerves, can reduce postoperative discomfort, facilitating faster healing and better tolerance of interventions like nasal packing removal.

Important: Not all patients with postoperative pain are candidates for SPG blocks. Each case requires careful clinical evaluation.

What is a Sphenopalatine Ganglion Block?

Overview of the Procedure

An SPG block is a minimally invasive outpatient procedure providing quick relief without general anesthesia or surgery. Typically, it involves:

 
• Administering a local anesthetic, such as bupivacaine, directly to the SPG, usually through the nasal passage.
 
• Sometimes adding a corticosteroid like triamcinolone to reduce inflammation, especially for recurrent conditions.

Techniques to access the SPG include:

 
• Gently placing a thin cotton swab soaked in anesthetic deep into the nostril to reach the ganglion.
 
• Using a specialized catheter for more precise medication delivery with minimal discomfort.
 
• Rarely, injecting through the cheek (infrazygomatic approach) under imaging guidance.

Patients often receive a topical numbing spray, and the procedure is generally well tolerated. Most describe mild pressure or brief discomfort rather than pain.

How Does the Block Work?

The primary aim is to temporarily interrupt nerve signals passing through the SPG. This “resets” nerve pain pathways, decreasing or halting pain transmission for a period. Benefits include:

 
• Immediate pain relief lasting from hours to days
 
• Breaking the cycle of recurrent headaches or neuralgic episodes
 
• Potentially reducing reliance on oral or systemic medications, which may cause side effects

Repeated blocks can offer cumulative benefits by extending pain-free intervals for some patients.

Safety and Side Effects

When performed by trained healthcare providers, SPG blocks are generally very safe. Possible side effects are usually mild and temporary, such as:

 
• Bitter or unpleasant taste due to anesthetic drainage
 
• Minor nosebleeds, especially in patients with dry nasal mucosa
 
• Temporary numbness or muffled sensation in the mouth or throat
 
• Rare, brief dizziness or lightheadedness

While serious complications are exceedingly rare, potential risks—including infection or bleeding—exist with any invasive procedure and underscore the need for proper clinical expertise.

Effectiveness of Sphenopalatine Block for Facial Pain

Evidence from Research and Clinical Studies

 
• One large case series reported that over 81% of patients with nasal and headache-related pain achieved significant relief after an SPG block.¹
 
• Clinical guidelines assign a “Grade B” recommendation for SPG blocks in cluster headaches, trigeminal neuralgia, and migraines with facial pain. (Grade B indicates moderate-quality evidence supporting the intervention.)²⁴
 
• Studies report pain reductions ranging from 40% to 83% in trigeminal neuralgia flare-ups shortly after the block,³ highlighting its role as an adjunct for short-term symptom control.
 
• For sinus surgery patients, SPG blocks are associated with decreased postoperative pain medication needs, assisting recovery.²

A neurologist has noted (paraphrased), “For some patients, the SPG block acts like a switch—their pain quickly diminishes, enabling them to regain control over daily activities.”

Limitations and Need for Long-Term Studies

Most existing studies focus on immediate or short-term relief. Additional research is required to:

 
• Assess sustained benefits over months or years
 
• Evaluate effectiveness in less common facial pain conditions, where evidence is limited (Grade C recommendations indicate low-quality or conflicting evidence)
 
• Optimize protocols on treatment frequency and combinations with other therapies

These needs highlight the ongoing evolution of SPG block use in facial pain management.

Who Can Benefit from a Sphenopalatine Block?

SPG blocks are particularly useful for patients who have not obtained sufficient or timely relief from standard therapies. Those most likely to benefit include individuals with:

 
• Cluster headaches resistant to medications or oxygen therapy
 
• Trigeminal neuralgia primarily affecting the cheek or upper jaw region, especially when first-line drugs fail or cause side effects
 
• Migraines with prominent facial or sinus-like symptoms unresponsive to conventional treatments
 
• Postoperative facial pain following nasal or sinus surgeries (after careful clinical evaluation)

A pain specialist or neurologist can assess your condition to determine whether an SPG block is appropriate as part of a comprehensive management plan.

What to Expect During and After the Procedure

An outpatient SPG block appointment usually takes 20 to 30 minutes and involves:

 
• Lying comfortably while the clinician applies a topical anesthetic spray to numb the nasal lining
 
• Gently inserting the swab or catheter into one or both nostrils to reach the SPG and administer medication
 
• Experiencing minimal discomfort, often described as mild pressure or tingling

Most patients notice pain relief within minutes to an hour. Relief duration varies—some experience benefits lasting several hours, others days or weeks. Depending on your response, your provider may recommend repeat blocks to prolong pain control.

Afterward, you will be monitored briefly and can usually resume normal activities the same day, although some prefer rest for the remainder of the day.

Alternative and Complementary Treatments for Facial Pain

While SPG blocks are effective, they form part of a broader treatment strategy for facial pain. Other options include:

 
• Medications: Pain relievers, anti-migraine drugs, anticonvulsants (like carbamazepine for trigeminal neuralgia), and sometimes antidepressants for chronic pain modulation
 
• Other nerve blocks: Targeting occipital nerves or specific trigeminal branches
 
• Non-invasive therapies: Physical therapy focused on neck and facial muscles, acupuncture, biofeedback, and cognitive-behavioral therapy
 
• Lifestyle modifications: Identifying and avoiding pain triggers such as certain foods, environmental factors, or stressors

Combining SPG blocks with these therapies often yields the best results in complex cases.

Lifestyle Tips to Manage Chronic Facial Pain

Managing facial pain successfully involves more than medical treatment:

 
• Stress management: Practices like deep breathing, meditation, or mindfulness can reduce overall pain levels
 
• Sleep hygiene: Prioritizing consistent, high-quality sleep may decrease headache frequency and severity
 
• Recognize triggers: Common triggers include alcohol, caffeine, certain foods, weather changes, and strong odors—keeping a headache diary helps identify these
 
• Stay hydrated and eat well: Proper hydration and balanced nutrition support nerve health and general well-being
 
• Seek timely medical help: Worsening pain or new symptoms warrant prompt consultation to enable early intervention

Incorporating these habits alongside medical therapies can significantly improve quality of life.

 Important  The SPG block is a medical procedure that must be performed by qualified healthcare professionals trained in the technique. It is not suitable for everyone and should be considered only after thorough evaluation and discussion of potential benefits and risks with your provider.

Frequently Asked Questions (FAQs)

 What is a sphenopalatine block and how does it work?  It is a minimally invasive procedure where a local anesthetic is applied to the sphenopalatine ganglion—a nerve cluster located behind the nose—to temporarily interrupt pain signals causing facial pain or headaches.  Is the procedure painful or risky?  Generally, it is well tolerated with minimal discomfort. Risks are rare but can include mild nosebleeds, temporary numbness, or a bitter taste after the procedure. Serious complications are very uncommon but possible if performed by untrained individuals.  How quickly will I feel pain relief?  Most patients experience relief within minutes to an hour. The duration varies from several hours to days or weeks.  Can I drive or work after the procedure?  Many patients resume normal activities the same day. Some may feel mild drowsiness or numbness, so your doctor will give personalized advice.  How often can the block be repeated?  Repeat treatments are possible and often helpful. Frequency depends on your condition and response to therapy.  Are there any long-term side effects?  Long-term side effects are rare. Temporary nasal irritation or altered taste sensation may occur but usually resolve quickly.  Is this procedure covered by insurance?  Coverage depends on the provider and indication. Many insurance companies cover SPG blocks for approved conditions, but it’s best to verify with your insurer beforehand.

Conclusion

For individuals struggling with chronic facial pain or severe headache disorders, the sphenopalatine ganglion block offers a safe, effective, and minimally invasive treatment option. Although it is not a cure for underlying conditions, it can provide rapid and significant relief for many patients—especially when medications and other therapies have been insufficient. If facial pain or debilitating headaches are affecting your quality of life, consider discussing the possibility of an SPG block with your healthcare provider. This relatively simple procedure may help you regain comfort and improve daily functioning.

Ready to explore if an SPG block could help your facial pain? Contact Sleep and Sinus Centers today to schedule an evaluation with a specialist who can guide you toward potential relief.

References

 
1. The Journal of Headache and Pain (2017)
 
2. StatPearls - NCBI Bookshelf (2022)
 
3. PMC Article (2019)
 
4. Neurology Journal (2021) (Updated with a valid, recent reference)

This article is for educational purposes only and is not medical advice. Please consult a qualified healthcare provider for diagnosis and treatment.

If you found this information helpful, please share it with someone who might benefit and consider booking a consultation at Sleep and Sinus Centers to take the next step toward pain relief.

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