Sphenopalatine Ganglion Block
Sphenopalatine Ganglion (SPG) Block and Selected Radiofrequency Procedures
The sphenopalatine ganglion is a parasympathetic ganglion located in the pterygopalatine fossa and has been targeted in selected headache and facial-pain syndromes. An SPG block uses local anesthetic delivered by an appropriate technique to temporarily modify signaling in this region.
Evidence varies substantially by diagnosis and technique. SPG block has been studied in selected cluster headache, migraine, trigeminal/facial pain, and perioperative settings, but the evidence is not equally strong for each condition. Published evidence for SPG radiofrequency treatment is more limited and diagnosis-dependent.
Expectations and Risks
Benefit is not guaranteed and is often temporary. Risks depend on the approach and can include unpleasant taste or throat numbness with transnasal techniques, bleeding, infection, medication reaction, temporary sensory changes, and injury to nearby structures with needle-based approaches.
You will arrive at our clinic 15 minutes prior to your appointment with or without a designated driver where we will educate you at length on the benefits & risks of the procedure. After this discussion we will then have you sign a consent form and you will subsequently be positioned in preparation for the procedure.
An antiseptic alcohol solution will then be used to clean the site of injection & surrounding skin to help decrease chances of infection. The procedure site will then be identified under ultrasound guidance. Once the site is appropriately identified an injection of a numbing medication called lidocaine will be administered to numb the site of injection & surrounding skin. Once the lidocaine has settled the sphenopalatine ganglion will receive an injection cocktail consisting of an anesthetic (bupivacaine) and a steroid (kenalog). This cocktail disperses and bathes the nerves allowing targeted medication delivery with with response varying from patient to patient of their chronic facial pain and/or headaches. You will then be observed for an additional 10-15 minutes following completion of the procedure to ensure your safety and then scheduled for post-procedural follow up by our staff.
What To Expect After Procedure
● Possible improvement in pain of the affected area
● Pain relief ranging from days to months
● Acute short term mild swelling or pain around the injection site
Risks Associated With Sphenopalatine Ganglion Block
● Misplacement of the needle
● Unexpected bleeding
● Drug allergies
● Infection
● Nerve damage
● Worsening pain
Clinical Evidence, Limitations & Patient Selection
SPG block has variable evidence across headache and facial-pain diagnoses; the strongest data are diagnosis- and technique-specific. Radiofrequency evidence is more limited than block evidence.
Important limitation: The page should distinguish SPG block from SPG RFA and avoid implying broad effectiveness for all chronic headache or facial pain.
Every procedure has potential risks, and individual benefit cannot be guaranteed. Recommendations at Solutions in Pain are based on the diagnosis, examination, relevant imaging, prior treatment, medical history, medications, patient goals, current evidence, and applicable payer requirements.
Selected Evidence & Guidelines
Patient-education content updated September 2026. This information does not replace an individualized medical evaluation or informed-consent discussion.
