The Spheenopalatine Ganglion (SPG) Block has a 100+ year history of treating many types of headaches and migraines and is considered a treatment of choice for cluster headaches.  It was originally described by Greenfield Schluder who went on to become chair of the Dept of Otolaryngology at Washington University Medical School in St Louis.  Dr Schluder was the author of  the medical test, Nasal Neurology.

The Sphenopalatine Ganglion is the largest Parasympathetic Ganglion of the head and  aalso carries sympathetic fibers from the Superior Sympathetic Chain.  It is part of the Autonomic nervous system.  The SPG Bock has been called the “Miracle Block” and was featured in the book “Miracles on Park Avenue” which chronicled Dr Milton Reder’s use of SPG Blocks.  Patients came from across the world to see Dr Reder for relief of pain and many other symptoms..

In 1930 Dr Hiram Byrd published a paper in the Annals of Internal Medicine (JAMA)  “Sphenopalatine Phenomenom”on 10,000 blocks in 2000 patients with virtually no negative side effects and improvements in many multiple disorders.
Especially headache and facial pain, sinus pain, ear pain, and eye pain .

There are several new catheters designed for delivering non-invasive topical anesthetic to the Sphenopalatine Ganglion, also known as the pterygopalatine Ganglion.  One of the best methods is still the one originally described by Schluder in 1908.  The cotton-tipped Catheter is an amazing improvement offering continual capillary feed to give long term relief and even permanently eliminate many issues.

Patients with chronic headaches and migraines are often best served by learning to self-administer SPG Blocks with cotton-tipped nasal catheeters.  This can often give almost immediate relief to headaches and migraines.  Side effects iclude decreased anxiety and depression.  Approximately one third of essential hypertension is eliminated by SPG Blocks which turn off the Sympathetic “Fight or Flight” reflex and turn on Parasympathetic “Eat and Digest” or “Feed and Breed” reflex.

These blocks have also been used to treat anxiety, PTSD, Fibromyalgia and many other common disorders.  W
hile they may not cure the underlying condition they do offer amazing relief from the troubling symptoms effective offering enormous help in restoring quality of life to patients.

Dr Ira Shapira teaches courses in Sphenopalatine Ganglion Blocks to treat headaches, migraines, facial pain, orofacial pain and TMJ disorders in his Highland Park Office.   He teaches his patients how to self-administer the SPG Block as well.

SPG Block for Headaches and Migraines: Sphenopalatine Ganglion Blocks help Orofacial Pain Treatment and Differential Diagnosis

This brand new article looks at use of the SPG Block for treating postdural puncture headaches.  The postdural puncture headaches were treated more effectively andwith less complications utilizing Sphenopalatine Ganglion Blocks than doing Epidural Blood Patch.  Epidural Blood Patch has been the standard treatment but often can create complications.


PubMed Abstract below:
Reg Anesth Pain Med. 2018 Nov;43(8):880-884. doi: 10.1097/AAP.0000000000000840.

Topical Sphenopalatine Ganglion Block Compared With Epidural Blood Patch for Postdural Puncture Headache Management in Postpartum Patients: A Retrospective Review.



Postdural puncture headache (PDPH) is a severe and debilitating complication of unintentional dural puncture. The criterion-standard treatment for PDPH has been epidural blood patch (EBP), but it is an invasive intervention with the potential for severe complications, such as meningitis and paralysis. We believe this is the first ever 17-year retrospective chart review in which we compare the effectiveness of sphenopalatine ganglion block (SPGB) to EBP for PDPH treatment in postpartum patients.


We conducted a chart review of the first authors’ obstetric patients who experienced PDPH from an unintentional dural puncture from a 17-gauge Tuohy needle for labor epidural from January 1997 to July 2014. Demographic characteristics, headache severity, and associated symptoms were collected prior to treatment. Forty-two patients who received SPGB and 39 patients who received EBP were identified. Residual headache, recovery from associated symptoms, and new treatment complications were compared between the 2 groups at 30 minutes, 1 hour, 24 hours, 48 hours, and 1 week posttreatment.


A greater number of patients showed significant relief in their PDPH and associated symptoms at 30 and 60 minutes after treatment with SPGB than after treatment with EBP (P < 0.01). Only the EBP patients complained of posttreatment complications, which all resolved in 48 hours.


A greater number of patients experienced a quicker onset of headache relief, without any new complications, from treatment with SPGB versus EBP. We believe that SPGB is a safe, inexpensive, and well-tolerated treatment. We hope that clinical trials will be conducted in the future that will confirm our findings and allow us to recommend SPGB for PDPH treatment prior to offering patients EBP.