A sphenopalatine ganglion (SPG) block delivers anesthetic to a nerve relay behind the nose. It reboots the overactive circuit behind cluster headaches and certain migraines. A stellate ganglion block calms a sympathetic nervous system stuck in fight-or-flight. At the Padda Institute, both are the start of a plan, not the end of one.
Cluster headaches and severe migraines are not simple discomfort. They take lives apart. Maybe you have already ridden the standard merry-go-round: triptans, dark rooms, caffeine, and preventive drugs that leave you foggy. If so, you may want something more precise. This article explains how two targeted procedures, the sphenopalatine ganglion (SPG) block and the stellate ganglion block, work inside the nervous system. It also explains why, at the Padda Institute, they are only the start of a plan.
Pain is a signal, not a diagnosis
At the Padda Institute we see pain differently. Pain is an alarm. It comes from your nervous system, your metabolism, or your body’s structure. It tells you that something has drifted deeply out of balance. For primary headache disorders like cluster headaches and migraines, that view matters. The goal is not just to mute the alarm. It is to find the exact relay in the nervous system that is firing. Then, as a separate question, we ask why it became so easy to set off in the first place.
How does a sphenopalatine ganglion (SPG) block work?
The sphenopalatine ganglion is a complex bundle of nerves deep behind the nose. It is a major relay station for the autonomic nervous system (the system that runs body functions on autopilot). In cluster headaches and certain migraines, this relay goes into overdrive. It gets trapped in a feedback loop of pain and inflammation. By precisely delivering anesthetic to this ganglion, a pain physician can “reboot” the overactive circuit. It is a targeted strike on the nerve source of the attack, not a vague, whole-body treatment.
Can an occipital nerve block help chronic migraine?
Many patients with chronic migraine also have a cervicogenic component. That means the nerves at the base of the skull are squeezed or inflamed. An occipital nerve block gives instant feedback. It both tests and treats. If the block relieves your pain, it confirms that these nerves are a major part of your pain signal. If it does not, that is useful too, and the workup moves to the next layer.
What does a stellate ganglion block do for headaches?
The stellate ganglion block acts on the sympathetic nervous system. It matters most for patients whose headaches get worse because their nervous system is stuck in constant fight-or-flight. Calming that overdrive can break the pattern that keeps the headaches coming back.
Why isn’t a nerve block alone enough?
Here is the view you will rarely hear in a typical pain clinic. Much of the pain-procedure industry runs like an assembly line of endless monthly injections. Nobody asks why your nerves are so easy to set off. If we perform an SPG block but ignore your metabolic health, we are failing you. Maybe your insulin stays high. Maybe body-wide inflammation goes untreated. Maybe your sleep is broken. Then a block only silences the alarm for a while. It is a band-aid on a leak in the wall. We use the window of relief a block gives us to treat the ground underneath: metabolic markers, inflammation levels, and lifestyle.
Frequently asked questions
What is a sphenopalatine ganglion (SPG) block?
An SPG block delivers anesthetic to the sphenopalatine ganglion. That is a bundle of nerves behind the nose. It acts as a relay station for the autonomic nervous system. In cluster headaches and some migraines this relay goes into overdrive. The block can break that feedback loop of pain and inflammation. Individual results vary.
For where the SPG block fits among fast-acting cluster headache treatments, read How to Stop a Cluster Headache: Treatments That Work in Minutes.
How is a stellate ganglion block different from an SPG block?
An SPG block targets a relay behind the nose that is part of headache circuits. A stellate ganglion block acts on the sympathetic nervous system, the fight-or-flight system. Stellate blocks matter most when a headache disorder gets worse from a nervous system stuck in long-term stress. Your doctor picks the procedure based on your own symptoms and exam.
Will one nerve block cure my cluster headaches?
A block can break an active cycle and give real relief. On its own, though, it only silences the alarm for a while. At the Padda Institute the block is used to break the acute suffering. It opens a window to treat the drivers underneath: insulin, inflammation, and sleep. Do not start, stop, or change any prescribed headache medication on your own. Individual results vary.
For why a procedure alone rarely fixes chronic pain, read Why Medications, Procedures, and Surgery May Not Fix Chronic Pain.
Where are these procedures performed and how do I book?
Procedures are done at the Padda Institute Center for Interventional Pain Management, 4477 Woodson Rd, Suite 100, St. Louis, MO 63134, minutes from Lambert International Airport. Book at painmd.tv/appointment/ or call (314) 481-5000.
What type of doctor performs a ganglion block?
An interventional pain physician. The physician delivers anesthetic precisely to the target. That is either the sphenopalatine ganglion behind the nose or the stellate ganglion, which acts on the sympathetic nervous system. The doctor picks between them based on your own symptoms and exam. These procedures are done at the Padda Institute Center for Interventional Pain Management in St. Louis.
Does a stellate ganglion block work for headaches?
It matters most when a headache disorder is made worse by a nervous system stuck in constant fight-or-flight. The stellate ganglion block acts on that overdrive. Calming it can break the pattern that keeps the headaches coming back. It works best as the start of a plan that also treats metabolic health, inflammation and sleep. Individual results vary.
Can a nerve block show what is causing my headaches?
Yes. A targeted block both tests and treats. If an occipital nerve block relieves your pain, it confirms that the nerves at the base of the skull are a major part of your pain signal. If it does not, that is useful too, and the workup moves to the next layer.
Key takeaways
- Cluster headaches and migraines are pain signals from an overactive nervous system, not just discomfort.
- SPG and occipital nerve blocks target specific headache circuits. Stellate ganglion blocks calm fight-or-flight overdrive.
- A targeted block both tests and treats. Relief helps confirm the source.
- Blocks work best as the start of a plan that also deals with metabolic health, inflammation, and sleep.
This article is educational and is not a substitute for evaluation, diagnosis, or treatment by a physician. Individual results vary. Do not start, stop, or change any medication without consulting your physician.
Find the source of your pain — not just the signal
Padda Institute Center for Interventional Pain Management builds a customized, root-cause plan for each patient. Interventional care and metabolic medicine, under one roof in St. Louis.
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In an active cluster bout?
A sphenopalatine ganglion block takes only a few minutes, uses no needle through the skin and no sedation, and is often used during a bout to break the cycle. The Padda Institute offers same-day and emergency visits — no referral needed, and you do not need to be an existing patient. Call or text us.
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP — Board Certified in Anesthesiology, Pain Medicine, Interventional Pain Management, Addiction Medicine, and Obesity Medicine. Last reviewed July 2026.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
