The costs of chronic migraine are a burden to patients, insurance companies and to government agencies. The cost to patients are staggering when one considers pain and suffering. The cost to family and relationships from living with chronic headaches is enormous with depression and family discord being a common outcome. Many patients feel terrible guilt due to their headache related disability.
Triptans and Botox have decreased the frequency and severity of migraine pain for some patients and hope is held the Calcitonin Gene-Related Peptides blockers could be a game changer. Unfortunately, Triptans, Botox and the not yet approved CGRP Blockers are all expensive, beset with a host of negative side effects but most important are just not that effective for most patients.
When patients end up in Emergency Departments they often wait for hours, have unnecessary CAT Scans or MRI and a single vist can run into thousands of dollars. Often patients feel criticized for being there or are accused of drug seeking behavior.
Sphenopalatine Ganglion Blocks have over 100 year record of success in treating and preventing a wide variety of chronic pain conditions. The Original technique described by Greenfeld Sluder in 1903 was applying 10% cocaine solution on a cotton pledget and applying it to the nasal mucosa overlying the Pterygopalatine Fossa where the Ganglion resides attached to the maxillary division of the Trigeminal Nerve.
A newer method of using this technique that I teach can be life changing for patients and save millions or even billions in annual costs of treating headaches and migraines. More important is it drastically reduces the suffering of patients giving them hope for a better life.
The Sphenopalatine Ganglion Block was the subjects of two books by Sluder, the second Nasal Neuralgia. In 1930 Hiram Byrd reported in the Annals of Internal Medicine (JAMA) the results of over 10,000 blocks in over 2000 patients with virtually no side effects. Today it is believed that Sluder’s Neuralgia was either Migraine, Cluster headache or severe TMJ disorder.
How can such an effective and safe procedure be forgotten? New medications and drugs started to be produced and doctors began to believe that everything could be fixed by a pill. The Sphenopalatine Ganglion Block may have disappeared but that changes with the publication in 1986 of the popular book “Miracles on Park Avenue” that told the story of how Dr Milton Reder and ENT in New York City was curing thousands of patients with a wide variety of ailments including all types of headaches, fibromyalgia, and joint pain utilizing just these blocks.
I originally learned the technique in 1986 when a patient brought me in the book and asked be to find someone who could dot the procedure for him in Chicago. I read the book in one night and was astounded that no one knew how to do this simple butr amazing procedure. I later learned of a colleague Dr Jack Haden in Kansas City new the procedure and travelled there to learn it. I learned by first Jack doing it and then by doing it on myself.
I have been using the SPG “Miracle” Block since 1986. I used it as an adjunct procedure in my TMJ, Headache and Migraine Treatment practice. I utilize Neuromuscular Dentistry to eliminate these same disorders and began to teach my patients how to self administer the blocks. I also taught my patients how to utilize Travell Spray and Stretch Techniques to turn off pain.
I later moved from cotton tipped applicators to cotton tipped nasal catheters than offer continual capillary feed of lidocaine to the nasal mucosa. I utilized cocaine for a very short time and then switched to 4% lidocaine with almost identical results and no paperwork from the DEA. I currently utilize 2% lidocaine and still see great results.
Self-Administration of the Sphenopalatine Ganglion Block by the patient in the comfort of their home is how these blocks are most effectively used. If a patient is suffering from severe head pain they will frequently delay seeking treatment and eventually end up in the Er often with bills of thousands of dollars. If on the other hand a patient can use $1.00 worth of supplies and turn off or decrease the pain and avoid the hospital visit everyone is ahead. Costs and suffering are drastically reduces and quality of lif improves. The quality of life for the patient and their family in the waiting room of the hospital is close to zero.