A sphenopalatine ganglion block may help evaluate or temporarily reduce selected migraine, cluster headache, TAC, facial pain, or eye-region headache patterns.
Learn how Dr. Siefferman performs sphenopalatine ganglion (SPG) blocks to help treat chronic headaches, migraines, and certain facial pain conditions.
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Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine and board-certified headache specialist. For patients with craniofacial pain or persistent atypical headaches, we will sometimes consider a sphenopalatine ganglion block. The sphenopalatine ganglion is located behind the nose, and what we will do is we’ll have the patient lie down with their head off the edge of the bed and we’ll use drops of lidocaine, or numbing medicine, which run up the nose past that cribriform plate to the sphenopalatine ganglion and numb it, and we see what that does. It’s often very helpful for pain in the mask area and light sensitivity.
A sphenopalatine ganglion block, often called an SPG block, is a targeted procedure used to deliver numbing medication near the sphenopalatine ganglion, a nerve structure involved in certain head, face, and autonomic pain pathways. It may be considered for selected patients with migraine, cluster headache, trigeminal autonomic cephalalgia, facial pain, or headache behind the eye.
At Manhattan Pain Medicine, sphenopalatine ganglion block NYC care begins with diagnosis-first headache evaluation. The goal is to determine whether the SPG region may be contributing to symptoms and whether a block may provide diagnostic information, temporary relief, or both.
MPM specialists evaluate whether an SPG block may be appropriate by first clarifying the headache or facial pain pattern. Pain behind the eye, one-sided headache, facial pressure, tearing, nasal congestion, light sensitivity, migraine symptoms, cluster headache patterns, and trigeminal autonomic symptoms can overlap. MPM reviews symptom location, triggers, autonomic features, headache frequency, medication response, prior blocks, imaging history, neurological symptoms, and red flags. This helps determine whether an SPG block, occipital nerve block, trigeminal nerve block, Botox for migraine, medication management, peripheral nerve stimulation, neuromodulation, or neurological evaluation may be more appropriate.
Patients often search for an SPG block in Manhattan when headaches are severe, recurrent, one-sided, behind the eye, associated with facial pain, or accompanied by autonomic symptoms such as tearing, nasal congestion, facial pressure, or eye-region pain. Some patients have already tried acute medications, preventive medications, Botox for migraine, occipital nerve blocks, trigger point injections, neurology care, imaging, or headache specialist treatment.
MPM approaches sphenopalatine ganglion blocks as a targeted tool within headache care, not a universal migraine treatment or a cure. An SPG block may be used diagnostically, therapeutically, or as part of a broader care plan for selected headache and facial pain patterns. The response may help clarify whether trigeminal-autonomic pathways are involved and may guide next steps. If the block does not help, MPM may reassess whether symptoms are more consistent with migraine, cluster headache, hemicrania, TACs, sinus-related pain, trigeminal neuralgia, or another headache or facial pain source.
Sphenopalatine ganglion blocks fit within MPM’s Headache and Complex Chronic Pain expertise because headache and facial pain often involve overlapping nerve, autonomic, musculoskeletal, and central pain pathways. A patient may have chronic migraine, cluster headache, trigeminal autonomic cephalalgia, facial pain, pain behind the eye, neck-related headache, or complex pain sensitivity at the same time.
MPM uses SPG blocks as one possible tool within a broader diagnosis-first framework. A block may provide useful information and temporary symptom relief, but it is rarely the entire answer. Treatment planning may also include headache classification, medication review, migraine prevention, Botox for migraine, peripheral nerve blocks, ultrasound-guided injections, pain psychology, neuromodulation, or coordination with neurology when appropriate.
Before a sphenopalatine ganglion block, MPM reviews the headache diagnosis, facial pain pattern, autonomic symptoms, prior treatments, medication history, risks, alternatives, and post-procedure instructions. Depending on the approach, medication may be delivered through the nose to reach the SPG region, or an image-guided approach may be considered in selected cases.
Patients may experience nasal discomfort, a bitter taste, throat numbness, temporary facial or nasal numbness, dizziness, nausea, or local irritation. Relief, if it occurs, may be temporary and may last hours, days, or longer depending on the headache pattern and medication used. Some patients may not respond. MPM reviews the response after the block to determine whether the SPG region appears clinically relevant and whether additional headache or facial pain treatment should be considered.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
ZocDoc
This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
ZocDoc
Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
ZocDoc
Dr. Siefferman is a genius. He is very informed and listens attentively.
ZocDoc
Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
ZocDoc
Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
ZocDoc
Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
ZocDoc
A sphenopalatine ganglion block is a procedure that delivers numbing medication near the sphenopalatine ganglion, a nerve structure involved in certain head, facial, and autonomic pain pathways. It may be considered for selected patients with migraine, cluster headache, trigeminal autonomic cephalalgia, facial pain, or headache behind the eye. At MPM, sphenopalatine ganglion block NYC care begins with diagnosis-first evaluation to determine whether this target fits the patient’s headache pattern.
The sphenopalatine ganglion is a nerve structure located deep in the face, behind the nasal cavity. It is connected to trigeminal and autonomic pathways that may be involved in certain headache and facial pain patterns. This is why some patients with one-sided headache, pain behind the eye, facial pain, tearing, nasal congestion, or autonomic symptoms may be evaluated for an SPG block. MPM determines whether this pathway is clinically relevant before recommending treatment.
An SPG block is another name for a sphenopalatine ganglion block. “SPG” is the abbreviation for sphenopalatine ganglion. The procedure is designed to deliver medication near the SPG region to temporarily interrupt selected pain pathways. It may be used diagnostically, therapeutically, or as part of a broader headache plan. It is not a cure and is not appropriate for every headache or facial pain condition.
An SPG block may be considered for selected migraine patients, especially when migraine involves facial pain, pain behind the eye, cranial autonomic symptoms, or refractory flares. It is not a universal migraine treatment and does not replace migraine prevention, acute medication, Botox for migraine, or neurological evaluation when those are needed. MPM evaluates the patient’s migraine pattern, prior treatment response, red flags, and broader care plan before recommending an SPG block.
An SPG block may be considered for selected patients with cluster headache patterns, especially when severe one-sided pain around the eye occurs with autonomic symptoms such as tearing, nasal congestion, facial sweating, or restlessness. Cluster headache requires accurate diagnosis and a broader treatment plan. An SPG block may provide temporary relief or help guide care, but it does not cure cluster headache or replace appropriate headache management.
An SPG block may be considered in selected trigeminal autonomic cephalalgia patterns because these headaches often involve one-sided head or facial pain with autonomic symptoms. However, TACs include different conditions, and treatment depends on the specific diagnosis. MPM evaluates whether symptoms are consistent with cluster headache, hemicrania, another TAC, migraine, trigeminal neuralgia, or another headache disorder before recommending an SPG block.
An SPG block may help selected facial pain or pain behind the eye when the symptoms appear to involve trigeminal-autonomic pathways. Similar symptoms may also come from migraine, cluster headache, sinus disease, trigeminal neuralgia, eye conditions, dental disease, or secondary headache causes. MPM evaluates the full symptom pattern and screens for red flags before recommending an SPG block or another treatment.
An SPG block can be diagnostic, therapeutic, or both. A diagnostic block may help determine whether the SPG region is involved in the pain pathway. A therapeutic block is intended to reduce symptoms for a period of time. Relief is often temporary, but it can still be clinically useful. MPM reviews how much relief occurred, where relief occurred, and how long it lasted before recommending next steps.
An SPG block may be performed through an intranasal approach, where medication is delivered through the nose toward the SPG region. In selected cases, image-guided approaches may be considered. The technique depends on the diagnosis, anatomy, clinical goal, and safety considerations. MPM reviews the planned approach, expected sensations, risks, and alternatives before the procedure.
Many SPG blocks are performed through the nose using an intranasal approach. This allows medication to reach the region near the sphenopalatine ganglion without a deeper injection in some cases. Patients may notice nasal pressure, local irritation, bitter taste, throat numbness, or temporary facial or nasal numbness. Some clinical situations may require a different approach, which MPM reviews before treatment.
The duration of relief varies by patient, headache diagnosis, medication used, and pain mechanism. Some patients may experience relief for hours, while others may have improvement for days or longer. Some patients may not respond. Relief is often temporary. MPM uses the timing, degree, and location of relief to help determine whether the SPG region is clinically relevant and what next step may be appropriate.
Temporary relief can still be clinically meaningful. It may suggest that the SPG region or trigeminal-autonomic pathway is contributing to the pain pattern. Depending on the response, MPM may consider medication management, repeat evaluation, Botox for migraine, occipital nerve block, trigeminal nerve block, peripheral nerve stimulation, neuromodulation, or neurology coordination. If relief is limited or unexpected, the headache diagnosis may need further refinement.
An SPG block targets the sphenopalatine ganglion region, which is involved in certain facial, autonomic, and headache pathways. An occipital nerve block targets nerves at the back of the head and upper neck. Occipital blocks may be more relevant for pain at the back of the head or scalp tenderness. SPG blocks may be considered for selected headache patterns involving eye-region pain, facial pain, or autonomic symptoms. MPM determines the target based on the pain pattern.
An SPG block targets the sphenopalatine ganglion region, which is connected to trigeminal and autonomic pathways. A trigeminal nerve block targets a specific branch of the trigeminal nerve. Trigeminal blocks may be considered for selected facial pain in the forehead, cheek, jaw, or dental regions. SPG blocks may be more relevant when headache or facial pain includes autonomic symptoms such as tearing, nasal congestion, or pain behind the eye.
Risks may include nasal discomfort, bitter taste, throat numbness, temporary numbness, dizziness, nausea, nosebleed, local irritation, allergic reaction, incomplete relief, temporary relief only, or no relief. Image-guided approaches may also involve bruising, bleeding, infection, vascular injury, nerve irritation, or local anesthetic toxicity. MPM reviews risks before treatment. Sudden worst headache, new neurological deficits, vision loss, severe facial swelling, chest pain, trouble breathing, or rapidly worsening symptoms require urgent evaluation.
An SPG block may not be appropriate when symptoms do not suggest SPG or trigeminal-autonomic pathway involvement, when headache red flags require urgent evaluation, when infection or nasal pathology needs evaluation first, or when another treatment pathway is more appropriate. It is not a replacement for headache diagnosis, medication management, migraine prevention, neurological evaluation, imaging when indicated, emergency care, or broader pain care.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If you are considering a sphenopalatine ganglion block in NYC for migraine, cluster headache, TAC symptoms, facial pain, pain behind the eye, autonomic headache symptoms, or complex headache patterns, MPM can help determine whether this treatment may be appropriate. Your evaluation will consider your headache diagnosis, symptoms, prior treatments, safety factors, and care goals before any recommendation is made.
A sphenopalatine ganglion block, often called an SPG block, is a targeted procedure that delivers medication near the sphenopalatine ganglion. The SPG is a nerve structure located deep in the face, behind the nasal cavity. It is connected to trigeminal and autonomic pathways that may be involved in certain headache and facial pain conditions.
At Manhattan Pain Medicine (MPM), sphenopalatine ganglion block NYC care begins with diagnosis-first headache evaluation. The goal is to determine whether the SPG region may be contributing to symptoms and whether a block may provide diagnostic information, temporary relief, or both.
The SPG is associated with head, facial, and cranial autonomic pathways. This is why an SPG block may be considered for selected patients with migraine, cluster headache, trigeminal autonomic cephalalgia, facial pain, or pain behind the eye. Some patients have symptoms such as tearing, nasal congestion, facial pressure, eye-region pain, or one-sided headache.
These symptoms do not automatically mean the SPG is the source of pain. Migraine, cluster headache, hemicrania, TACs, tension headache, trigeminal neuralgia, sinus-related pain, eye conditions, dental disease, cervical pain, and secondary headache causes can overlap. MPM evaluates the pattern before recommending treatment.
An SPG block may be diagnostic, therapeutic, or both. A diagnostic block may help determine whether the SPG region or trigeminal-autonomic pathway is involved. A therapeutic block is intended to reduce symptoms for a period of time.
Relief may occur quickly in some patients, especially when local anesthetic reaches the intended region. In others, relief may be delayed, brief, incomplete, or absent. Temporary relief can still be useful because it may help guide future care. MPM reviews the degree, timing, location, and duration of relief before recommending next steps.
SPG blocks may be considered for selected migraine patients, especially when migraine symptoms include facial pain, pain behind the eye, or autonomic features. They may also be considered for selected cluster headache or TAC patterns, where one-sided head or facial pain is associated with tearing, nasal symptoms, eyelid changes, sweating, or restlessness.
An SPG block does not cure migraine, cluster headache, hemicrania, TACs, or chronic headache. It also does not replace headache classification, migraine prevention, acute medication, Botox for migraine, neurology care, or imaging when indicated. It may be one tool within a broader headache plan.
An SPG block is different from an occipital nerve block, trigeminal nerve block, or glossopharyngeal nerve block. An occipital nerve block targets nerves at the back of the head and upper neck. A trigeminal nerve block targets branches of the trigeminal nerve in the face. A glossopharyngeal nerve block targets cranial nerve IX, which may be involved in selected throat, tongue, ear, or tonsillar pain.
MPM chooses the target based on the patient’s pain distribution, triggers, autonomic symptoms, headache classification, neurological findings, and prior response to treatment.
Many SPG blocks are performed through an intranasal approach, where medication is delivered through the nose toward the SPG region. In selected cases, an image-guided approach may be considered. The technique depends on anatomy, diagnosis, clinical goal, and safety factors.
Patients may notice nasal discomfort, bitter taste, throat numbness, temporary facial or nasal numbness, dizziness, nausea, or local irritation. Some may have temporary relief, while others may not respond. MPM reviews the response and uses it to guide future treatment planning.
Risks may include nasal discomfort, bitter taste, throat numbness, temporary numbness, dizziness, nausea, nosebleed, local irritation, allergic reaction, incomplete relief, temporary relief only, or no relief. For image-guided approaches, risks may include bruising, bleeding, infection, vascular injury, nerve irritation, and local anesthetic toxicity.
Patients should seek urgent evaluation for sudden worst headache, new neurological deficits, vision loss, confusion, fever, stiff neck, trauma, cancer history, immune suppression, pregnancy or postpartum headache, new headache after age 50, headache with fainting, severe facial swelling, chest pain, trouble breathing, or a major change in headache or facial pain pattern.
For selected patients, an SPG block may be a useful part of understanding and managing headache or facial pain. MPM’s role is to determine whether the SPG is the right target and how the block fits within a coordinated, medically responsible headache care plan.
