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739070 tn?1338607002

Anyone heard of spheno-palatine ganglion blocks?

Went to see the pain management across from the MS Institute on Friday. The doc sees a lot of MS patients for chronic pain so there is a modicum of trust there. My MS neuro (from anther institute referred me there.

When I went for my first visit, he perform a spheno-palatine injection via the nasal cavity. Not too bad , just uncomfortable.  According to the doc this ganglion (supply of nerve cell bodies). It innervates the the fifth cranial nerve which affects the face and trigeminal nerves among others.

The treatment plan was 3 injections a week apart and if these were successful then 3 ketamine infusions, each a week apart. I understood how this could possibly improve my face pain, migraines and trigeminal neuralgia but was confused by how it would help the bone pain in my legs. His response it this ganglion innervates the spinal column and carries nerves to the other parts of the body. I wasn't thoroughly convinced (always the skeptic) but was game for anything involving decreased face pain and headaches. He tended to bombards DH and me with a large amount of information in a short amount of time.

So, the injection with Marcaine went well and lo and behold the bone pain in my leg disappeared. Granted it could have been a placebo effect , but who cares as it stayed away until today. Today ,it's all back with a vengence including the dreaded increased fatigue.

Has anyone heard of this technique or am I being fed a line of bull. Any and all comments welcome!

Ren
20 Responses
1045086 tn?1332130022
Wow Ren, I hadn't heard of it but I'm certainly glad I have now!!  I'm going to ask the woman who does my massage and energy work about this but I can't reach her today.  Her training is informal but she knows all about the energy and nerve centers in the body (mine, our horses, our dog....).  She worked wonders in reducing my pain and getting me functional before my MS was diagnosed -- you know, during that time when the doctors cared but couldn't do more than test and head scratch and apologize.  I know she wouldn't be able to perform this type of service but I'd love to hear what she has to say about it.

Your explanation from the pain management doc reminded me of eastern medicine and accupuncture principle.  If nothing else because of how one point is connected to many others instead of standing alone.  So I tried to do a little search.  I did come up with a few sources in the orient.  The link I'm going to post mentions that this procedure was known and written about in the 1930's (as the eastern medicine guys said too).  It is mentioned as easy and effective but under-utilized.  Imagine that!!

I'm sure many here will be interested to see how this process goes for you and if you can get some lasting relief.  How wonderful this might be for MICHELLERIC!!  I hope she sees it and asks her pain neuro.  Wonder why he wouldn't mention it if he knows of it.  So much better than narcotics!!

Do you suppose this is why kids so enjoy shoving misc stuff up their noses????

Thanks so much for sharing.  Let us know what he says about the return of your pain and what you can expect down the line.  I don't need this myself at the moment but I sure am going to be investigating the availability in our area come Monday.

Mary
1045086 tn?1332130022
Forgot the link.  Here it is.

http://primehcp.com/nerveblock.html
1045086 tn?1332130022
Ren, was this an injection or did he place cotton tipped applicators in the area?  What is the doc's definition of success for the initial three treatments?  Must you have all three before he moves on to the ketamine?  How does that procedure differ?  Is this a costly treatment?  Covered by insurance I assume?  As always, only if you know these answers or care to share.

I come from the skeptic arena too but have become more of a believer since supplements and non-traditional treatment have helped me greatly the last few years.  Pain management physicians have quite a bag of tricks to use if you can get in to see them and convince them you are more interested in relief than drugs.

There is a video on You Tube that shows a woman getting a Spenopalatine block treatment.  Besides her stated pain relief, her face and body language say her energy level improved significantly, as you reported.

Mary
739070 tn?1338607002
Mary,

Thanks for the link. I did find this in research as well as Dr. Sluder's work (excerpts),
Yes, I immediately thought of Michelle when this was explained and even more so when I read that article.

Of course, my kids said they want to watch mom "get high" on the ketamine. That part I'm not looking forward to but the doc promised Valium to decrease the "dissociated feeling" that accompanies the the ketamine.

Again, thanks and if you find anything new ,please let me know.
Ren
739070 tn?1338607002
Mary,
Actually, his technique differed slightly from the descriptions I found online. A 6 inch lidocaine impregnated q-tip was placed in each nostril and after a few minutes to take effect, he injected the cotton tip with Marcaine. This was probably the most uncomfortable feeling because my throat was numb from the lidocaine but I still felt the need to swallow as the Marcaine ran down my throat, and felt that I couldn't. The doc looked and assured me I was "not drowning". The feeling did pass rather quickly.

As the Marcaine started working I experienced a brief spell of dizziness, identical to my migraine vertigo so I'm not sure of the source of that sensation. It passed quickly.  The q-tips were left in place 15-20 minutes. Pain scale when I arrived was 7 and 3 when I had just completed the treatment. After spending 20 minutes lining up 6 more follow-up appts. , the pain level was 0!

I'll have to check out the You Tube video, thanks for the tip!

Ren
645390 tn?1338558977
Ren, and Mary,

Thanks SO much for sharing your experience and thinking of me.

Actually I did see a pain doc, before this new pain neuro, about 6 months ago. He recommended exactly this procedure, but explained it much differently.  He told me it is a 50?50 chance that it will work, and then if it does, they go back and deaden the nerve.

I know it was different because he couldn't do it at the time because I was on Coumadin.  I know his involved sticking a needle from the outside of my face very far, into the trigeminal nerve.  I still have the brochure he gave me somewhere, I will have to go find it. Very interesting...

My new Pain neuro said it wouldn't work for me, because I have 4 cranial nerves involved, and it "might" help a bit, but wont get to the source of the problem.

From reading his letter to my MS neuro, the only thing he suggested if ALL else fails was something I don't understand and haven't looked it up, because I really don't want to know. (Ignorance is bliss sometimes)

It was Neuromodulatory surgery for evaluation of a central stimulator to stop the MS progression, if possible.

Anyway, I am so glad it has worked for you Ren, I am thrilled for you and hope it continues to help!

Hugs,
Michelle
739070 tn?1338607002
Michelle,

I wasn't given a guarantee and was told the effects differ greatly between patients., I asked the average time of relief per procedure and he said 12-14 hours..some longer, some shorter. My actual total time  being pain free was about 10 hours, but I'll take it.

Today I have a sore throat brewing and feel like c*ap and of course the pain is back but I also have the fatigue accompanying a relapse so at least I have slept 18-20 of the last 24 hours.


Mary,
I forgot to answer some of your previous questions. Re insurance, I assume it is covered as we had to waited for insurance approval before he would begin because in his words " you  don't want to pay for this out of pocket", I'm assuming it's expensive..but what isn't if it's MS related?

My pain doc is a DO and if he follows his training , he should approach this from a holistic point of view. But, as I said before, my DH and I were taken aback with  the deluge of information in such a short amount of time...reminiscent of a used car sales man, lol

In fact, I woke up to make BLT's for dinner and am heading back to bed after being up only an hour and a half. I will keep you updated as the weeks go by and tell you about the success of  my procedures. What I find weird and want to research is a statement the doc made about the ketamine"resetting the" nervous system and bring it down a notch to lessen the pain.

Back to bed with a raging "migraine' or whatever it is and bilateral face pain.

Thanks ladies!

I'll update with my weekly results for the next 6 weeks...

Ren
572651 tn?1531002957
Ren,
This is very interesting reading here - thanks for starting this and thanks to Mary and Michelle for your contributions.  I now have some new drugs to go and read about.  I look forward to reading your updates, but even more I hope we will hear that you continue to improve with this treatment.  -L
1045086 tn?1332130022
Ah yes, the holistic DO.  Luckily, there are many here in Ohio.  

My insurance coverage channels me in the direction of the MD initialed these days.  Most of my specailists are of that schooling but I've hung onto my DO family practice docs and pay the slightly higher co-pay for the pleasure and priviledge.  

We used to have an entire osteopathic hospital just 15 miles from home.  Unfortunately, it's doors closed a few years back when an over-zealous woman attempted to convert the useful community facility into a center for cardiac surgery excellence.  Very sad.  Not much can compare with seeing an Amish buggy or two at the hitching post when you pull into a hospital outpatient parking lot.  These days they are forced to rely on the conglomerate hospital's motorized transportation assistance.  But I've gone far afield now and totally forget where I intended to be.

Mary
1045086 tn?1332130022
Now I remember.  Is the DO pain management specialist also an anesthesiologist?

Michelle, are you sure your last pain specialist was talking about this same procedure?  Why stick a needle through your face when a swab up the nose will do the trick?  Seems like a question worth askin'.

Mary
739070 tn?1338607002
Mary,
Yes he is also an anesthesiologist or else he would NOT be giving ketamine IV in a doctor's office (although, it is connected to a hospital).

Michelle,
I agree with Mary, the end result may be the same but why not do the q-tip trick when that will cause NO bleeding?

ren
645390 tn?1338558977
I guess I am really going to have to look for that brochure.  Perhaps it was a procedure that sounded like a similiar name? I will try to check tomorrow, or I guess later today.  I am up @ 2:30 in the morning with a severe back/leg ache. I think I am getting the flu perhaps? I hope not.

Michelle
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