What is Sphenopalatine Ganglion Block (SGB)?
The treatment itself appears to be quite simple. The doctor places a small thin cotton-tipped nasal applicator, which looks a bit like a Q-tip (but smaller) in the nose and leaves it there for about 30 minutes. Placing the applicator is painless; the cotton has been treated with a solution of local anesthetic similar to the Novocain used by dentists, so there is only a slight sensation of having anything in the nose.
After 30 minutes the applicator is removed and the treatment is over. What the treatment is actually doing is not so simple, however. While in place, the cotton tip is applying local anesthetic to a tiny nerve center located in the nose, the sphenopalatine ganglion.
It certainly sounds obscure, but if you have ever suffered from an ice cream headache (these occur when the ganglion is irritated by cold food), you know just how powerful the sphenopalatine ganglion is! This little nerve center happens to be the only place in the entire body where the three branches of the nervous system—Sympathetic, Parasympathetic, and Somatosensory-- come together AND are exposed to the outside world, via the nose.
There are other important nerve centers buried deep within the body which require invasive, sometimes painful, deep injections or even surgery to access them. Because the Sphenopalatine Ganglion is in the nose, it can be accessed easily and non-invasively, without pain or discomfort. There is no injection or incision, so there is no risk of bleeding or infection.
Because it is non-invasive and, when performed by a trained practitioner, essentially free of risk, it is usually worth trying in a wide variety of clinical situations, especially when other measures have failed or have proven inadequate in controlling chronic pain.
For cluster headaches, neuralgias of the face and head, and any musculoskeletal condition where muscle spasm is prominent (i.e. low back strain, sciatica, herniated disc) and a range of other conditions, SGB serves as a first-line treatment, even before pain medication, manipulation, and certainly before surgery is contemplated.
Although sometimes mis-classified as an “alternative” treatment, for the above reasons SGB is often the more conservative approach.