The Sphenopalatine Ganglion Block has been used to treat pain since 1908 when Greenfield Sluder first described it to treat Sluders Neuralgia a severe  pain condition that is now thought to be cluster headache, another Trigeminal Autonomic Cephalgia or a TMJ disorder.  Dr Sluder later went on to become the chair of the Department of Otolaryngology at Washington University Medical School in St Louis and to write the first medical textbook on Nasal Neurology.

This article discusses the use of SPG Blocks (SPGB) to treat Nasal Contact Headaches or Contact Headaches that occur from pathological contact of septum to turbinates.  This can also be a cause of severe facial pain or migraines.  This specific case looked at a case study of a 46 year old female patient with frontotemporal headache.  This severe headache was medication resistant but the SPG Block gave 6 months of relief.  Afrin Nasal Spray or oxymetazolie can be used to shring the tissues over the septum and turbinates which could relieve the pain of contact headache by eliminating contact.

Contact headaches could be cured by eliminating the contact point and the use of Afrin nasal spray could be used to predict success.

Cranio. 2018 Jun 8:1-3. doi: 10.1080/08869634.2018.1475859. [Epub ahead of print]

Efficacy of sphenopalatine ganglion block in nasal mucosal headache presenting as facial pain.


Background When intranasal contact points are the cause of headache and facial pain, opinions regarding whether to remove intranasal contact points when they are believed to be the cause of headache and facial pain are divided. Clinical Presentation A 46-year-old woman visited the authors’ pain clinic with complaints of right nasal pain accompanied by frontotemporal headache. She first met an Otorhinolaryngologist and a neurologist. Based on nasal endoscopy and pain pattern, they presumed that her pain was a nasal mucosal headache rather than migraine. A mild septal deviation to the right side with bony spur near the inferior turbinate was observed. The use of medication provided very insufficient relief. However, the sphenopalatine ganglion (SPG) blockprovided excellent pain relief, and the effect lasted for six months. Conclusion Considering the mechanism of pain in intranasal contact point headache, (SPG) block is a potentially effective therapeutic tool.


Sphenopalatine ganglion block; facial pain; nasal mucosal headache; trigeminal afferent nerves