This interesting article (abstract below) details a report of Sphenopalatine Ganglion Block being utilized for lower limb Chronic Regional Pain Syndrome. The first case was not controlled with oral medication and a sympathetic block did not provide significant relief. A Sphenopalatine Ganglion Block provided a 50% reduction in pain.
The second case also provided a 50% reduction in pain in a patient with CRPS.
The Sphenopalatine Ganglion is the largest parasympathetic ganglion of the head. Sympathetic fibers from the superior cervical ganglion pass thru the Sphenopalatine Ganglion.
SPG Blocks are typically used to treat headaches, chronic daily headaches, migraines, cluster headaches, hemicrania continua, TMJ disorders and orofacial pain disorders. Reduction of blood pressure and reduction of feelings of anxiety have also been reported. There are also studies showing the effectiveness of Sphenopalatine Ganglion Blocks in treating cancer pain.
The 1986 book “Miracles on Park Avenue” detailed the medical practice of Dr Milton Reder who utilized SPG Blocks as a sole treatment for a wide variety of medical problems , many of which were resistant to all other treatments.
The Sphenopalatine Ganglion Block has been referred to as “The Miracle Block” for a very good reason, many patients who have exhausted medical alternative often find their answer in these easy, safe blocks.
Arch Phys Med Rehabil. 2005 Feb;86(2):335-7.
Complex regional pain syndrome involving the lower extremity: a report of 2 cases of sphenopalatine block as a treatment option.
Quevedo JP1, Purgavie K, Platt H, Strax TE.
We report 2 cases of complex regional pain syndrome (CRPS) involving the lower extremity; in both, a sphenopalatine ganglion (SPG) block was performed as part of a pain management program. In the first case, a woman in her late twenties presented with CRPS in the left lower extremity that was inadequately controlled with typical oral medications. Sympathetic block of the extremity did not provide significant pain relief. However, a noninvasive sphenopalatine block with 4% tetracaine resulted in a 50% reduction in pain level. The patient was shown how to self-administer the sphenopalatine block and was provided with exercises and therapy to help improve her functional status. The second case involved a woman in her mid forties with CRPS in the right lower extremity that was partially controlled with oral medications. The patient experienced a 50% reduction in pain level when SPG block with 4% tetracaine was given. Further study is needed to determine the effects of SPG blocks on symptoms related to chronic regional pain syndrome.
PMID: 15706564 DOI: 10.1016/j.apmr.2004.04.033