Targeted anesthetic to a branch of the trigeminal nerve, for facial pain and for headache with a strong facial component.
What the trigeminal nerve carries
The trigeminal nerve is the main sensory supply to the face, and it divides into three branches: ophthalmic (forehead and around the eye), maxillary (cheek and upper jaw), and mandibular (lower jaw). Which branch is blocked depends entirely on where your pain actually is.
The trigeminal system is also the pathway through which migraine and cluster headache generate pain, which is why blocks here can help headaches that are not obviously “facial”.
What it treats
- Trigeminal neuralgia — brief, electric, shock-like facial pain triggered by touch, chewing, cold air or shaving.
- Persistent pain after dental treatment — usually a trigeminal branch injured during an extraction, root canal or implant.
- Head and neck cancer pain, including pain after surgery or radiation.
- Persistent facial pain that has not responded to medication.
- Cluster and other trigeminal autonomic headaches, alongside oxygen and an SPG block.
How it is done
Superficial branches — supraorbital, infraorbital, mental — are reached through small injections at fixed landmarks, frequently with ultrasound to confirm the target and keep the needle away from the vessels that run with each nerve. Deeper approaches are done under fluoroscopy.
Numbness in the treated area afterwards is expected and temporary. There is no sedation for the superficial blocks.