Facial and Head Nerve Blocks

Trigeminal, sphenopalatine ganglion, and glossopharyngeal nerve blocks for trigeminal neuralgia, facial pain, and headaches that haven’t responded to other treatments.

Mountain Home870-706-2557
Harrison870-233-9960

Trigeminal nerve blocks

The trigeminal nerve carries feeling from the face through three main branches: the forehead and eye, the cheek, and the jaw. Trigeminal neuralgia causes sudden, severe, electric shock-like pain in one of these areas, often set off by chewing, talking, brushing teeth, or a light touch.1

Medication is usually the first treatment. A nerve block places numbing medicine, sometimes with a steroid, near the painful branch. It can calm a severe flare, provide relief while medicines are adjusted, and help confirm which branch is involved.1,2

Illustration of the trigeminal nerve and the three areas of the face it supplies
The trigeminal nerve’s three branches supply the forehead, cheek, and jaw.

Sphenopalatine ganglion blocks

The sphenopalatine ganglion is a small cluster of nerves deep behind the nose that plays a role in migraine and cluster headache. Blocking it with numbing medicine can help stop a severe headache or break a cycle of frequent attacks.3

  • Often needle-freeDepending on the technique, medicine may be placed through the nose with a thin, flexible applicator.
  • QuickUsually takes just a few minutes.
  • Can be repeatedSome people benefit from a short series of blocks.
  • For hard-to-treat headachesIncluding migraine, cluster headache, and some facial pain.

Glossopharyngeal nerve blocks

The glossopharyngeal nerve carries feeling from the back of the tongue, throat, and part of the ear. Glossopharyngeal neuralgia is a rare condition that causes sharp, stabbing pain in these areas, often set off by swallowing, talking, or coughing. A nerve block near the side of the neck, done with image guidance, can relieve pain and confirm the diagnosis.

How it works

  1. Pinpoint the nerve

    Your history and exam show which nerve or branch is causing your pain.

  2. Guided placement

    Depending on the nerve, the block is placed using landmarks, ultrasound, or X-ray guidance.

  3. Numbing medicine

    Local anesthetic, sometimes with a steroid, calms the irritated nerve.

  4. Track your relief

    You note how your pain and triggers change over the following days.

What to expect

Before your block

Tell us about your medications, including blood thinners, and any allergy to numbing medicine. Keep taking your prescribed nerve pain medicines unless we tell you otherwise.

During your block

Most blocks take only a few minutes. You may feel pressure, brief stinging, or numbness spreading over part of your face.

After your block

Numbness can last several hours. Avoid chewing or hot drinks until feeling returns if your mouth or face is numb. Relief may last days to weeks or longer.

Common questions

Is this a cure for trigeminal neuralgia?

Not usually. Blocks can provide meaningful relief, especially during flares, and many people use them along with medication. If pain keeps returning, we can discuss referral for other treatments, including surgical options.1

Will my face look different?

No. Your face may feel numb for a few hours, but its appearance and movement return to normal.

How often can blocks be repeated?

It depends on how long relief lasts and whether a steroid is used. Your physician will recommend a schedule that fits your response.

Will insurance cover it?

Most plans cover these nerve blocks when they are medically necessary. Our staff can check your benefits.

Talk with a specialist about facial pain or headaches

Our physicians will review your symptoms and prior treatments to decide whether a nerve block, or another treatment, is the right fit for you.

Schedule a consultation

New pain management patients need a referral. Your provider can fax it to 870-706-2428.

Risks

Possible side effects include temporary numbness, bruising or swelling, lightheadedness, bleeding, infection, and reactions to medicine. Glossopharyngeal blocks can briefly cause hoarseness or difficulty swallowing. Your physician will review the risks with you. Individual results vary.

Sources

  1. National Institute of Neurological Disorders and Stroke. Trigeminal Neuralgia. ninds.nih.gov
  2. Blumenfeld A, et al. Expert consensus recommendations for the performance of peripheral nerve blocks for headaches: a narrative review. Headache. 2013;53(3):437-446. doi:10.1111/head.12053
  3. Robbins MS, et al. The sphenopalatine ganglion: anatomy, pathophysiology, and therapeutic targeting in headache. Headache. 2016;56(2):240-258. doi:10.1111/head.12729

Illustration: BruceBlaus, via Wikimedia Commons, CC BY-SA 4.0, resized.