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Nerve Stimulator Study Shows Potential Benefit for Chronic Migraine

Pain is controlled by nerves. Some pain, like pain from touching a hot stove, teaches important protection lessons. With chronic pain, like chronic low back pain and migraine, the brain and nerves send pain messages that don’t provide useful information about avoiding an impending threat. Instead these nerve signals are nuisance messages that can be debilitating.

For patients who have failed standard medical treatment of chronic pain, invasive treatments that directly target abnormal nerve signaling can sometimes be helpful.

This approach is called neuromodulation, which means modifying nerve signaling. This is often done by sending electrical impulses to nerves. These devices counter the abnormal pain messages by sending their own electrical impulses. For example, spinal cord stimulators provide small electrical impulses to nerves near the spine. These stimulators are an established as a treatment for severe, disabling, recalcitrant pain that has failed more conservative treatments.

migraine nerve simulator
Illustration of the Genesisâ„¢ Neurostimulation System, an investigational device being evaluated in clinical research studies for chronic migraine headache. The Genesis system emits mild electrical pulses to generate peripheral nerve stimulation (PNS) of the occipital nerve in the back of the head.
migraine nerve simulator
Illustration provided by St. Jude Medical, Inc.

St. Jude Medical just released data from a study testing neuromodulation for chronic migraine. They tested a device that is implanted under the skin at the back of the head and delivers small, electrical impulses to the occipital nerves. The occipital nerves leave the top of the neck and travel over the back of the head. Other studies have shown that blocking activity of the occipital nerves through nerve blocks can temporarily reduce headache activity for some people. Using the newly tested nerve stimulation system, St. Jude Medical researchers reported a 28 percent decrease in headache frequency after 12 weeks compared with only a 4 percent drop among patients tested with a placebo.

What do these results mean for you? Should every migraine sufferer think about getting a nerve stimulator? Probably not. The people tested in this study had headaches nearly every day. The effectiveness was also less than what might be expected in the average migraine sufferer using more standard treatments. Neuromodulation may, however, proved to be a valuable option for those people with very frequent and disabling attacks who have given standard treatments a good try and have failed to respond adequately to those treatments. It will be important to watch as other studies are conducted by other researchers testing this device to confirm these initial good results.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • laalaa81
    6 years ago

    Is this treatment available in the UK. I still have a couple of months before I visit my neurologist again but would like to know if this is an option here before I see him. Thanks!

  • Michelle Mathis
    7 years ago

    I had a trial surgery for occipital nerve stimulator in Sept. of 2011. In the trial the only thing implanted were the wires going to the occipital nerves. The results were so good I could not wait to have the permanent surgery which took place in Oct. of 2011! The results have been wonderful! I would say the migraines have decreased by at least 75%! Don’t get me wrong~ I’m not cured, but now I can actually get out of bed almost every day. I have been struggling with migraines for close to 30 yrs and 6 yrs ago I actually attempted suicide! I have tried everything so when my neurologist sent me to a pain specialist and he immediately suggested surgery it was a no brainer! I would recommend it if you feel you have exhausted all other measures!

  • Lisa Abramowitz
    7 years ago

    I have been dealing with migraines since I was 9 but I eventually grew out of them except for the occasional migraine that I was able to manage with the help of a shot of immatrex. About 7years ago I was at work and felt a migraine coming on so I went and did my usual took shot but for some reason the shot didnt work as well. So after work I went to bed thinking I would just sleep it off, boy was I wrong after a few months I found myself getting worse… I was passing out from the pain and because of the vomiting I wasn’t able to keep any medication down. The passing out got so bad that I actually woke up to discover both of my feet were broken! So now the only other choice I had was to move back home with my parents. I went to every neurologist and migraine specialist I could find. Tried all the medications, all the treatments everything and anything the doctors suggested I did hopeful that something would work as the doctors ran out of ideas they would just pass me off to another and so on… out of all the procedures the only one that gave me any relief was the occipital injections but even they would only last for 10-15 minutes! Last week I was on the computer reading about the stimulator for the 100th time so I finally thought what the heck I found a doctor in my area (New Jersey) and went to see him. He said that he would do the “trial stimulator” but if it works the permanent one has to be done in Dallas Texas. But before I do anything I have to go to a seminar to meet people who are in different stages of having it done and then he would do it. Im very lucky to have a very supportive family im also very lucky to have the health insurance. Im very curious to know if those of you who have gone through what I have or worse has anyone had to go to the seminar before they could have anything done? And did anyone else have to go to Texas to get the permanent leads and stimulator? I was also wondering if anyone has tried something that I may not have, ya never know right! Thankyou very much for your time and any suggestions will be a great help! Thankyou again! ~LISA~

  • indigo3133
    7 years ago

    My migraines became dangerously problematic during my pregnancy. The OB/GYN and perinatologist recommended me to a pain specialist who did nerve blocks and morphine during the pregnancy, and after the birth of my premature but healthy baby, did a trial neurostimulator (occipital and supraorbital) without a bunch of red tape and I had some success with it so we went for the permanent one. While I didn’t experience total relief, it was enough at first for me to be able to return to work and be a mom to my new baby with the support of a loving dad/partner, my family, and the doctor and GP who has been helping me manage my pain. Although I have chronic migraine with persistent aura, the neurostimulator has helped. What makes the difference is the health care team with PROVEN experience and success with neuromodulation, the representatives and your own committment and support of those around you to help you better manage your pain. Here in San Francisco, my ace in was Dr. Elliot Krames. He knows his stuff, and when it comes to pain management, I would trust no one else but him and his team. I hope this helps.

  • Lisa Abramowitz
    7 years ago

    Cont …has anyone had to go to the seminar before they could have anything done? And did anyone else have to go to Texas to get the permanent leads and stimulator? And I was wondering if anyone has tried something else that I may not have,ya never know right! Thankyou very much for your time and any suggestions will be of great help! Thankyou again ~LISA~

  • Lisa Abramowitz
    7 years ago

    I have been dealing with migraines since I was 9 but I eventually grew out of them except for the occasional migraine that I was able to manage with the help of a shot of immatrex. About 7years ago I was at work and felt a migraine coming on so I went and did my usual took shot but for some reason the shot didnt work as well. So after work I went to bed thinking I would just sleep it off, boy was I wrong after a few months I found myself getting worse… I was passing out from the pain and because of the vomiting I wasn’t able to keep any medication down. The passing out got so bad that I actually woke up to discover both of my feet were broken! So now the only other choice I had was to move back home with my parents.
    I went to every neurologist and migraine specialist I could find. Tried all the medications, all the treatments everything and anything the doctors suggested I did hopeful that something would work as the doctors ran out of ideas they would just pass me off to another and so on… out of all the procedures the only one that gave me any relief was the occipital injections but even they would only last for 10-15 minutes!
    Last week I was on the computer reading about the stimulator for the 100th time so I finally thought what the heck I found a doctor in my area (New Jersey) and went to see him.
    He said that he would do the “trial stimulator” but if it works the permanent one has to be done in Dallas Texas. But before I do anything I have to go to a seminar to meet people who are in different stages of having it done and then he would do it. Im very lucky to have a very supportive family im also very lucky to have the health insurance.
    Im very curious to know if those of you who have gone through what I have or worse

  • Aamir Shakir
    7 years ago

    Ummm holy crap….

  • Tammy Walters Tyree
    7 years ago

    My husband is scheduled to have Stimpath on Nov. 29th of this month. Dr. Ken Reed with Ascendant Neurology of Dallas, TX is the inventor of this procedure specifically FOR chronic migraine patients. We went to Dallas and had the opportunity for my husb. to go thru a trial wearing the unit for about 3 days………..to his TOTAL AND COMPLETE AMAZEMENT, it worked and made his neck and head feel like it were brand new. If you lookup the practice I states above and type in Stimpath, it will give you all the info. The diagram stated above only shows the nerves in the bk of the head being stimulated, with the Stimpath stimulator, not only are the 2 nerves stimulated from the back, but the 2 supra orbital nerves are also stimulated in the front at the same time. So, for chronic migraine sufferers, this stimulation that takes place all at one time is PHENOMENAL! My husband had tears of joy as he went about his day with no neck pain and NO debilitating migraines. They have been doing Stimpath now for about 5-7yrs. and following the patients afterwards to see if the units are still working correctly. Julianne below is right! It IS life changing and I can’t wait for my husbands & our family’s life to change by this Christmas! We are blessed because we NEVER had one single denial from insurance. This is the only surgeries that Ascendant Neurology (Dr. Reed’s office) does now, because SO many people are finding out about it and having great success with it. The testimonials on the website are so poignant and real, as we sat and listened I just cried with hope and joy, because they, people I didn’t even know, were telling MY FAMILY’S store over & over again. This office works DAILY w/ insurance to get people approved and that is ALL they do. They know what to do and how to code it in order to have insurance approve it quickly. Don’t wait, you can get your life back in just a couple months after not having it for years.

  • Tammy Walters Tyree
    7 years ago

    This was an article in an online journal…just explaining the process so anyone who reads it and has regular migraines, could be helped.

  • Patti Caruso
    7 years ago

    I am definitely asking my doctor about this treatment and it’s possible pros and cons. I have suffered with Chronic Migraines (several times a week) for many years, And also wake up with a headache every morning. It is very stressful to have to rely on several different headache medicines (depending on the severity) to cope with this. I would love to be headache free for life!

  • Jen Land Golus
    7 years ago

    My pain management doctor is trying to get one of these for me. He says it is just like a switch. Turn it on and the headache is gone, turn it off and the headache comes back. I heard him saying this to his ne Physicians Assistant as I was going under for another nerve block…. I can only hope it wasn’t a dream and that my insurance company approves it.

  • Robin H
    7 years ago

    One of my sisters has something like this only it is implanted above her right eye. The battery pack is implanted in her abdomen and the cords run under skin from head to AB area. She is thrilled with it and says she’s never felt better and hasn’t had a headache since. She’s had it almost a year now and is so different in a wonderful way. Hope the one your doctor is looking at has such great results for you.

  • Julianne Zimmerman Alley
    8 years ago

    I have a stimulator which was implanted in 2009. It covers my occipital, trigeminal, and supraorbital nerves. I’d say it has reduced my pain by 80%. It’s been truly life changing. I’ve written a blog about my experience, and the overwhelming number of comments I receive are regarding inability to get insurance to pay for the procedure/implant. It kills me that the technology exists to help people manage their pain, and yet there’s someone behind a desk somewhere making the decision that they cannot get access to that treatment. I don’t understand why it matters which nerves stimulators are placed on for FDA approval. I mean, if they work on nerves in your back and are approved for that, what makes the nerves in your head or neck so different? It’s extremely frustrating.

  • Chester Lee
    8 years ago

    WELL GOOD TO KNOW, But could some one answer a question on migraine the young boy saids he hot then he said his head hurts went he goes to sleep with pain from 1 to 10 it be a 9 last about 16hrs, Do migraine come like this?

  • Kathy Jo Horton Bishop
    7 years ago

    they certainly do my current regimine for treatment is a combo of drugs that totally sedate me until it passes

  • Chester Lee
    7 years ago

    THANK YOU keep in touch Jen.

  • Jen Land Golus
    7 years ago

    Absolutley, I get sweats with my migraines and the only thing that helps is sleep or a med that will put me to sleep.

  • Bonni Currieri Lamey
    8 years ago

    I was part of this study in my city and it works! It has helped so much. I only works in the back of the head. but wow! I told they if they make one for the front I am all in!

  • Jen Land Golus
    7 years ago

    I am in central Nebraska and have a neurosurgan who will be putting mine into my occipitals. That pretty much covers from base of neck in back, over the top of head, and then most of your eye. I still feel some pain on the inside of the bridgeof my nose at my eye and my sinuses below my eyes in my cheeks.

  • Bonni Currieri Lamey
    8 years ago

    I will check into it. Thanks

  • Laura Giunti
    8 years ago

    Check out her surgeon then I can be next.

  • Julianne Zimmerman Alley
    8 years ago

    They do make them for the front. My stimulator covers the occipital, trigeminal, and supraorbital nerves. Unfortunately not all surgeons who put them in the occipital region do the other regions too because it’s a pretty tricky surgery (so I’m told).

  • Olovka Protiv Bolova
    8 years ago

    I am helping people with migraine and so many others chronic problems, I do stimulate subcutanous nerves on local painfull points and in 87% of times I kill the pain in 2 ways:
    – I kick up the production of endorphin in your body, more specificly, your brain;.
    – I block the pain impulse with my own.
    100% support to people with chronic problems.

  • Catherine Charrett-Dykes
    8 years ago

    I have this device…it is fantastic for the area I have covered….mine is still in the experimental stage.

  • Catherine Charrett-Dykes
    8 years ago

    cookie, they actually have those out already …lol

  • Michael Crispino Jr
    8 years ago

    I also have a device which is also fantastic for an area I want covered…. And you can consider mine in the experimental stage also.

  • Vicki Gewe
    8 years ago

    Re nerve blocks, even Medtronic and Dr. Dodick, who ran my trial, admitted that there doesn’t seem to be a real correlation, but I had to have a 50% reduction in pain with a nerve block to get in, which I did. So that was not an accurate measure in my case.

  • Vicki Gewe
    8 years ago

    I participated in a clinical t trial of an.occipital nerve stimulator for Medtronic at the Mayo Clinic in Scottsdale, AZ. Despite the study’s being run by all the top people at Mayo, it was a failure. It never did any good for me and even made me worse I was the last person to enter the trial, and less than a year later, I was one of the last to have my stimulator removed. They told me Mayo had decided to stop doing the trials because no one was getting real benefit. I now have permanent pain in my back from the scar tissue from the surgeries, where they connected the leads to the extension line. I will also add that I’ve networked with several others who have had stimulators, but no one has had significant benefit. I’m surprised they’re even considering approving them and I’d encourage people to think twice before getting one. If the top surgeon at the Mayo Clinic, as well as the people who pioneered this device, cannot get it to work, then can the average neurosurgeon?

  • Catherine Charrett-Dykes
    8 years ago

    i’m also the last in my study in ny….mine has been wonderful, altho it did take me 4 surgeries to get it right

  • Dawn A Marcus
    8 years ago

    Occipital nerve blocks are often a good test to see whether the occipital nerves are an important contributor to your headaches. Occipital nerve blocks can themselves be an effective therapy for some migraine sufferers. In addition, if you find that occipital nerve blocks are helpful, this can sometimes suggest that working with a physical therapist to reduce muscle tightness and tenderness in the neck (that might be activating the occipital nerves) can also be helpful.

  • Dawn A Marcus
    8 years ago

    Before the FDA considers “approving” therapies, they usually like to see a number of clinical trials that all show the same good effect and safety. This is a long process. Most migraine treatments that your doctor might use — many of which are effective for most migraine sufferers — have not been FDA approved. Not being FDA approved doesn’t mean a treatment is necessarily not helpful or not safe.

  • Dawn A Marcus
    8 years ago

    The results from this clinical trial were just presented at a headache meeting in Berlin. A full publication of the study results, which will include a more detailed description of side effects, etc. should be published in a major headache journal later this year. Expected side effects would include those related to having a procedure (such as bleeding and infection) and device failure. An earlier review of studies evaluating occipital nerve stimulators for migraine published in the journal Pain Physician reported infection, lead displacement, and battery depletion as short-term side effects, with no long-term problems reported. The data from this study are particularly encouraging because the study design used an experimental method to more carefully analyze benefits. Because about 30 to 40 percent of migraine sufferers will experience at least temporary migraine relief from placebos, it’s important to test new treatments against a placebo to make sure the treatment is really working more than the placebo effect. More studies will likely be needed to confirm these early results so that doctors are comfortable having their patients try nerve stimulators for migraines that haven’t responded to other treatments.

  • scrapbookcindy
    8 years ago

    I would try again with your insurance, because I now have 2 stimulators implanted in me and once the trial was approved I never had trouble getting the permanent approved. I had my stimulator for my migraines implanted on 5/25/11. Well I have totally went off my Oxycontin which is excellent. In the second or third week I went 4 days with no pain meds at all. For some reason the last 2 to 3 weeks I’ve only had 2 days where I didn’t take any pain meds at all, but I do know from my first stimulator it does take a lot of adjustments to get it right & the stimulation doesn’t come all the way to my forehead where some of my headaches are. Of course this is a tool and not a cure, but it’s a big blessing that I’m off the Oxycontin.

  • Connie Davis
    8 years ago

    This past weekend I had a migraine that always seems to start in my eyebrow. I have had a TENS unit for about a yr now that I use on my neck & back due to fibromyalgia muscle pain. I decided to put one of the leads on my eyebrow and turned it on very low. To my amazement, even though it did feel rather uncomfortable, in the long run, the impulses that were flowing through the TENS unit ended up feeling GREAT! I still had to take my migraine medications and layed on a heating pad and slept, but I DID get relief from using this. It didn’t cause any after effects (which I worried about using close to my eye) and I did feel a little numbness till the next afternoon, but I.

  • Laura Bagley Asher
    8 years ago

    I had trial nerve stim implants done in fall 2009. It was done without anesthesia except a local at the insert site. It hurt soooo much. They have to have you awake and aware to test that the nerve stimulators are placed correctly and buzz to mask the pain. It felt like the doctor was shoving 2 knitting needles between my scalp and my scull over and over again. Basically undermining my scalp to find the correct placement. After that’s done, I’m stitched up, and plugged in, the stim rep programs the control unit for different settings and instructs on how to use it. I used the stimulator for 5 days. One side worked about 80%, the other side slipped out of place and was only 20% effective.
    Slipping and burnout of the rods are some of the complications. The battery pack and wires for the permanent stim are placed under the skin. This can always cause irritation. To make the stim work you need to move your head and neck around to find the spot to feel the stimulation. It basically replaces the pain sensation.
    My doctor was new in town and didn’t get the proper authorization from the insurance company. The procedure and stim implant was denied and I had to fight to have the $45,000 charges written off since I was told it was covered. Luckily I was in network and succeeded.
    By this time I was way past Percocet and Fentynal Patch on to methadone.
    Of course I FINALLY got sent to a neurosurgeon instead of a pain specialist, which is what I’d been asking for for 4 years, only to find out that my last MVA rear-ending 4 years earlier whip-lashed my neck so hard the screws came out from the first fusion, put in a year and a half earlier. It took 20 plus years to find that problem and fix it. It was had to diagnose because I also have migraines and the daily HA’s. Neurologists only wanted to treat the migraines, even though I told them I knew a lot of the pain came from my neck.
    Oh well. May be having another surgery again soon to remove more bone spurs. The last surgery my doctor had to take them off because they were growing into my spinal cord. No more methadone though. Almost as painful quitting as the nerve pain.

  • Louise M. Houle
    8 years ago

    Could you also address the issue of complications or side effects of the implant? Thank you.

  • Diana Lee
    8 years ago

    Also, I just ran across a Reuters article about this study & it said “Wall Street analysts” don’t think it will get FDA approval for chronic migraine. Do they have any idea what they’re talking about?

  • Catherine Charrett-Dykes
    8 years ago

    it was just approved in germany….won’t be long here

  • Diana Lee
    8 years ago

    Can you address the relationship between occipital nerve blocks and occipital nerve stimulators? If the nerve blocks are ineffective for a particular patient does this have any bearing on whether that person is a good candidate for the nerve stimulator?

  • Heather Zanitsch
    8 years ago

    Great questions!

  • Shannon
    8 years ago

    I had the trial Neuromodulation back in October 2009. After a very successful trial, with few problems. I had to have it removed approximately 3 weeks after was placed due to scar tissue over a couple of the electrodes. So the dr who placed the trial referred to me the surgeon who was going to place the perminent neuromodulation unit. I was told insurance was not paying for this treatment & they had 25 people on a waiting list. After finding something that relieved my migraines for the first time in over 10 years, I was denied by the insurance. Which makes no sense due to the fact they approved the trial. So I do agree that it can help people for migraines but before you put all kinds of money out towards deductable, out of pocket expenses or anything like that, be sure your insurance will pay for the perminent. I had over $3000 in medical bills from out of pocket expenses before my insurance would pay bills at 100%. Just saying this happened in 2009, maybe things have changed by this year.

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