Headache caused by Acute Rhinosinusitis (ICHD-3: 11.5.1 and Headache attributed to chronic or recurring Rhinosinusits (ICHD-3; 11.5.2) have specific diagnosis codes in the International Classification of Headaches but this does not answer the question of the best treatment for these disorders.
It is generally accepted that narcotics and other pain medications are probably not indicated (contra-indicated) in the majority of patients.
The treatment likely to give the fastest relief in these types of headaches is a Sphenopalatine Ganglion (SPG) Block which can often give almost instantaneous relief and also reduce anxiety and create a sense of general well being.
SPG Blocks are actually indicated as a treatment for Vasomotor Rhinitis. The problem with this treatment is that it requires a trip to your physician, neurologist, ENT physician or emergency room. I have taught hundreds of Neuromuscular Dentists (ICCMO.org) to use my technique.
Self-administration of Sphenopalatine Ganglion Blocks is an easy procedure and ideally it can be done as an attack begins before the patient experiences increasing pain, anxiety or triggering of a more severe migraine headache.
I routinely teach patients to Self-Administer these blocks in my practice.
www.ThinkBetterLife.com. I have also built a site dedicated to the art and science of Sphenopalatine Ganglion Blocks and to promote their use and the concept of self-administration.
This link is to an article on that site concerning sinus and nasal issues with SPG Blocks.
The following is a video of a man who became a physician after experiencing a Sphenopalatine Ganglion Block during an Acute Sinus Headache which gave him excellent relief. He specifically became a physician to help patients but never learned the technique and after 10 years left the practice of medicine and became an artist. I took this video the day he learned for the first time what a Sphenopalatine Ganglion Block was.
https://www.youtube.com/watch?v=Sn46l_nH9-A
While the reason to do an SPG Block may be to treat the severe pain, long-term these "Miracle Blocks" can actually help the body recover from the original condition. The book "Miracles on Park Avenue" detailed the practice of Dr Milton Reder an NY city ENT whose entire practice was delivery of SPG Blocks.
According to ICHD-3 these headaches can be mistaken for Migraine and Tension-Type Headache. If the diagnosis is one of these other types of headaches the same block will still give almost immediate relief in a majority of patients. This video is a patient who suffered severe migraines for 10 years shortly after she had her first SPG Block:
https://www.youtube.com/watch?v=DCPLDRJ2twg&t=1s
What is the Sphenopalatine Ganglion? It is the largest Parasympathetic ganglion of the head and is located in the Pterygopalatine fossa on the maxillary division of the trigeminal nerve. It carries both somaticsensory nerve fibers and autonomic nerve fibers from both the sympathetic and the parasympathetic divisions. It was originally described in 1903 bu Sluer and is often called Sluder's Ganglion. It is also known as the Nasal Ganglion, the Pterygopalatine ganglion and Meckel's ganglion.
Sluder described instant relief from "Sluder's Neuralgia" after a transnasal block. This is now thought to be either a Cluster Headache or TMJ disorder.
There are multiple methods to preform Sphenopalatine Ganglion Blocks. They can be done by intra-oral or extra-oral injections but are more commonly done with nasal catheters or cotton-tipped applicators.
There are three commercial nasal catheters available, the Sphenocath which is the first and the one I utilize in some patients with tight nasal passages. The Allevio whic is similar to the Sphenocath. The third type is the TX 360 that has a double barrel approach for delivering anesthetic to right and left nostrils. that I now have available in my office and is the device used specifically for the MiRx protocol. They are all basically "squirt guns" designed to deposit anesthetic over the nasal mucosa the covers the very thin plate of bone covering the Sphenopalatine Ganglion.
My preferred method of delivery SPG Blocks is a cotton-tipped nasal catheter that delivers continual capillary feed of lidocaine to the same area where the Sphenocath, the Allevio and the TX 360 deliver anesthetic. The nasal ctheter can be used straight from the package or can be adapted for even better results.
The reasons I utilize the cotton-tipped catheters are:
1. It is very easy to teach the majority of patients to self-administer SPG Blocks.
2. It is very cost effective allowing patients to self administer bilateral SPG blocks for less than $1.00. The other devices are designed for single use and cost approximately $75.00 for the device.
3. Continual capillary delivery is far more effective based on my observations and is more convenient for the patient. Ideally using the other catheters that patient should lay supine (on back) for 20 minutes. The continual feed allows the patients to continue to do their normal daily activities while the block is working.
4. The block can be kept in for longer periods of time and can be used more frequently. Repetitive blocks can decrease frequency of headaches or eliminate them completely.
5. They are easily modified and patients can self modify as needed.
Sphenopalatine Ganglion Blocks are considered to be an under utilized pain management technique.
https://www.sphenopalatineganglionblocks.com/sphenopalatine-ganglion-block-underutilized-tool-pain-management/
The location of the Sphenopalatine Ganglion is very important and explains why Neuromuscular Dentistry is so effective in long term corrections of TMJ disorders and associated pain. The Myomonitor used to relax the muscles is a
ULF-TENS that also acts on the Sphenopalatine Ganglia acting as a neuromodulation technique. Neuromodulation of the SPG is being researched worldwide as a cure or treatment of migraines and other intractabler headaches.
There is a 50 year safety record of SPG neuromodulation with the Myomonitor.
It is generally accepted that narcotics and other pain medications are probably not indicated (contra-indicated) in the majority of patients.
The treatment likely to give the fastest relief in these types of headaches is a Sphenopalatine Ganglion (SPG) Block which can often give almost instantaneous relief and also reduce anxiety and create a sense of general well being.
SPG Blocks are actually indicated as a treatment for Vasomotor Rhinitis. The problem with this treatment is that it requires a trip to your physician, neurologist, ENT physician or emergency room. I have taught hundreds of Neuromuscular Dentists (ICCMO.org) to use my technique.
Self-administration of Sphenopalatine Ganglion Blocks is an easy procedure and ideally it can be done as an attack begins before the patient experiences increasing pain, anxiety or triggering of a more severe migraine headache.
I routinely teach patients to Self-Administer these blocks in my practice.
www.ThinkBetterLife.com. I have also built a site dedicated to the art and science of Sphenopalatine Ganglion Blocks and to promote their use and the concept of self-administration.
This link is to an article on that site concerning sinus and nasal issues with SPG Blocks.
Vasomotor Rhinitis Treatment with SPG Block
https://www.sleepandhealth.com/vasomotor-rhinitis-treatment-spg-block-sphenopalatine-ganglion-blocks/The following is a video of a man who became a physician after experiencing a Sphenopalatine Ganglion Block during an Acute Sinus Headache which gave him excellent relief. He specifically became a physician to help patients but never learned the technique and after 10 years left the practice of medicine and became an artist. I took this video the day he learned for the first time what a Sphenopalatine Ganglion Block was.
https://www.youtube.com/watch?v=Sn46l_nH9-A
While the reason to do an SPG Block may be to treat the severe pain, long-term these "Miracle Blocks" can actually help the body recover from the original condition. The book "Miracles on Park Avenue" detailed the practice of Dr Milton Reder an NY city ENT whose entire practice was delivery of SPG Blocks.
According to ICHD-3 these headaches can be mistaken for Migraine and Tension-Type Headache. If the diagnosis is one of these other types of headaches the same block will still give almost immediate relief in a majority of patients. This video is a patient who suffered severe migraines for 10 years shortly after she had her first SPG Block:
https://www.youtube.com/watch?v=DCPLDRJ2twg&t=1s
What is the Sphenopalatine Ganglion? It is the largest Parasympathetic ganglion of the head and is located in the Pterygopalatine fossa on the maxillary division of the trigeminal nerve. It carries both somaticsensory nerve fibers and autonomic nerve fibers from both the sympathetic and the parasympathetic divisions. It was originally described in 1903 bu Sluer and is often called Sluder's Ganglion. It is also known as the Nasal Ganglion, the Pterygopalatine ganglion and Meckel's ganglion.
Sluder described instant relief from "Sluder's Neuralgia" after a transnasal block. This is now thought to be either a Cluster Headache or TMJ disorder.
There are multiple methods to preform Sphenopalatine Ganglion Blocks. They can be done by intra-oral or extra-oral injections but are more commonly done with nasal catheters or cotton-tipped applicators.
There are three commercial nasal catheters available, the Sphenocath which is the first and the one I utilize in some patients with tight nasal passages. The Allevio whic is similar to the Sphenocath. The third type is the TX 360 that has a double barrel approach for delivering anesthetic to right and left nostrils. that I now have available in my office and is the device used specifically for the MiRx protocol. They are all basically "squirt guns" designed to deposit anesthetic over the nasal mucosa the covers the very thin plate of bone covering the Sphenopalatine Ganglion.
My preferred method of delivery SPG Blocks is a cotton-tipped nasal catheter that delivers continual capillary feed of lidocaine to the same area where the Sphenocath, the Allevio and the TX 360 deliver anesthetic. The nasal ctheter can be used straight from the package or can be adapted for even better results.
The reasons I utilize the cotton-tipped catheters are:
1. It is very easy to teach the majority of patients to self-administer SPG Blocks.
2. It is very cost effective allowing patients to self administer bilateral SPG blocks for less than $1.00. The other devices are designed for single use and cost approximately $75.00 for the device.
3. Continual capillary delivery is far more effective based on my observations and is more convenient for the patient. Ideally using the other catheters that patient should lay supine (on back) for 20 minutes. The continual feed allows the patients to continue to do their normal daily activities while the block is working.
4. The block can be kept in for longer periods of time and can be used more frequently. Repetitive blocks can decrease frequency of headaches or eliminate them completely.
5. They are easily modified and patients can self modify as needed.
Sphenopalatine Ganglion Blocks are considered to be an under utilized pain management technique.
https://www.sphenopalatineganglionblocks.com/sphenopalatine-ganglion-block-underutilized-tool-pain-management/
The location of the Sphenopalatine Ganglion is very important and explains why Neuromuscular Dentistry is so effective in long term corrections of TMJ disorders and associated pain. The Myomonitor used to relax the muscles is a
ULF-TENS that also acts on the Sphenopalatine Ganglia acting as a neuromodulation technique. Neuromodulation of the SPG is being researched worldwide as a cure or treatment of migraines and other intractabler headaches.
There is a 50 year safety record of SPG neuromodulation with the Myomonitor.
