What is the Pterygopalatine ganglion, and How do Blocks Work to stop migraine pain (SPG Nerve Block)?

When pain management physicians and other specialists target pain, a nerve block is sometimes used. As its name suggests, nerve blocking prevents transmission of pain messages within the nervous system so that pain is minimized or not experienced at all. When treating headaches and migraines, scientific research suggests that a specific ganglion (nerve bundle) within the face is an ideal target for optimal pain alleviation.

According to Cedars-Sinai, various conditions in the nerves – such as trauma and infection – can lead to sympathetic pain. One of the primary sites for sympathetic issues in the head is the pterygopalatine ganglion – also called the nasal ganglion, meckel's ganglion, and sphenopalatine ganglion (SPG for short) . Treatments directed toward this ganglion, preventing neural interaction, are called SPG nerve blocks.

Function of the ganglion & why nerve blocks are used

The pterygopalatine ganglion is located in a midface cavity called the pterygopalatine fossa. It's composed of three different types of nerves: sympathetic, parasympathetic and sensory. The pterygopalatine ganglion connects the brain neurologically to various elements of the face, such as the sinuses, mucous membranes, and lacrimal gland (which secretes water for the eyes).

SPG nerve blocks are simple treatments that use anesthesia on the area, to meet a variety of ends:

• pain management for a wide variety of headaches, including migraines
• pain management for chronic sympathetic pain of the face (a form of peripheral neuropathy called "sympathetically maintained facial pain")
• diagnosis of the source of head or face pain (essentially testing to see if it is effective).

How an SPG nerve block works

When the SPG is blocked, a medication is introduced to the ganglion to alleviate pain. When blocking is effective, a stress hormone and neurotransmitter called norepinepherine is released in lower quantities so that pain is less likely to be experienced. Treatments often use fluoroscopic tools (digital x-ray imaging) to enhance visibility.

Because the involvement of the pterygopalatine ganglion is minimal, the nerve block does not generate a numb sensation. It can also take a period of time for the injection to reduce pain. Many doctors recommend their patients keep pain journals to document the experience and better customize treatments.

MiRx™ Protocol is based on SPG blocking in conjunction with a well-respected pain management approach: multidisciplinary treatment. To read more about how MiRx™ prevents pain by blocking nerves, click here. For information on our various biomechanical therapies, click here