Migraine Treatment Through The Use Of Migraine Devices In Neuromodulation

Migraine is a common disorder, and you may experience throbbing pain that affects one side of the head. General body weakness and nausea often accompany migraines, making them harder to cope with. An attack typically subsides within two days, and chronic migraines happen more than 15 days a month.

The severity of your migraines can impact your life to the point where you may even require urgent medical attention.

Migraine medications reduce the frequency and severity of migraines. There are two categories:

• Preventive medications reduce the number of migraines you get.

• Acute (abortive) medications for every time a migraine starts. 

Over-the-counter (OTC) medications

People often use over-the-counter (OTC) medications for acute cases of mild and moderate migraines. 

Common pain relievers are:

• Aspirin

• Acetaminophen (Tylenol)

• Excedrin Migraine (it has both caffeine and pain-relieving properties)

• Ibuprofen 

Prescription medication

The following medications treat headache pain when you have a migraine:

Triptans

Triptans narrow blood vessels in your brain. You can get triptans as nasal sprays, injections, and pills.

Common triptans are:

• Rizatriptan (Maxalt)

• Almotriptan (Axert)

• Naratriptan (Amerge)

• Eletriptan (Relpax)

• Zolmitriptan (Zolmig)

• Frovatriptan (Frova)

• Sumatriptan (Imitrex)

Steroid injections 

In extreme cases, your doctor may inject you with steroids such as dexamethasone and prednisone.

Preventive medications

Preventive medications can take up to two months to start working. Two-thirds¹ of people who use preventive medications report a reduction in migraines by more than half.

Preventive medications include:

• Erenumab-aooe (Aimovig)

• Calcium channel blockers like verapamil (Calan, Verelan)

• OnabotulinumtoxinA (Botox) injections

• Beta-blockers such as metoprolol (Lopressor), propranolol (Inderal LA, Innopran XL), and timolol (Betimol)

• Antidepressants like amitriptyline (Elavil) and nortriptyline (Pamelor)

• Anti-seizure drugs such as topiramate (Topamax) and valproate (Depacon)

What is neuromodulation?

Neuromodulation² uses devices to reduce pain during migraines by slowing down the brain. The FDA has approved a few that meet specific medical and ethical requirements.

FDA-approved neuromodulation devices

Cefaly

Cefaly Dual Enhanced is an FDA-approved drug-free device for treating migraines. You place the device on your forehead, and it eases headache pain by transmitting impulses. These impulses restore the normal functioning of the nervous system. 

You should only use the device if you are at least 18 years old. Consult a doctor about Cefaly if you are over 65. The device is effective in the prevention and relief of migraines.

Cefaly is easy to use, and the main drawback is a slight tingling sensation. You should only use the device after consulting a doctor since it is only effective for migraines. 

The device is 46%³ effective, and you should speak to your doctor if a migraine persists.

To use Cefaly:

• Clean your forehead well with soap and water.

• Dry your forehead with a clean towel.

• Take the electrode from the packaging and attach it to your forehead. Place the curved area between your eyebrows.

• Attach the device magnetically to the electrode.

• Select "prevent treatment" if you are expecting a migraine. The treatment will last for 20 minutes.

• Select "acute treatment" if you already have a migraine. The treatment will last for one hour.

Spring TMS

The Spring TMS device uses magnetic waves to prevent migraines. The FDA approved the device for treating acute migraines with aura.

Transcranial magnetic stimulation (TMS) involves the creation of a short magnetic field. Magnetism causes mild electric currents in the brain, restoring nerve activity to normal. By negating the abnormal electric waves that caused the migraine, you experience symptom relief.

You should only use the device after a doctor has recommended it. The device is easy to use, and you can ask your doctor if you need help using it. eNeura says you should send the device back if you decide to stop using it. Contact them, and they will send you a prepaid return label. 

gammaCore

This device activates the vagus nerve by sending electrical impulses to the brain. This relieves migraines caused by abnormal nerve activity. GammaCore is drug-free, and you hold it behind your neck, so it isn’t something you need your doctor to implant. 

You should only use this device after your doctor has prescribed it. You may experience relief within 20-30 minutes. The treatment involves 2-minute sessions, one for each side of the neck. After the first treatment, you may experience up to two pain-free hours.

How does neuromodulation reduce the frequency of migraines?

You can apply neuromodulation using different methods, depending on your unique factors. Specialists recommend one of the following techniques: 

• Brain stimulation

• Peripheral nerve stimulation

• Spinal cord stimulation

• Spinal drug delivery systems

Migraine devices act similarly to cardiac pacemakers: They restore normal nervous system function. A good example is pain management using spinal cord stimulation.

A surgeon places a thin wire (or lead) outside the spinal cord. They connect the wire to a generator they’ve put under the skin, typically in your back. The device constantly sends low-voltage electrical impulses to your brain.

The advancement of neuromodulation devices has improved comfort; you experience less pain, and the impulses transmitted by the device are hardly noticeable.

Another application of neuromodulation is administering medications directly in the areas you need them, bypassing other tissues in the body. A miniature pump often delivers the drug into your spinal fluid. The spinal drug delivery system device uses a catheter connected to a small pump.

The medicine is put in the pump and released in small doses so you can continue with your daily activities. The technique will improve your quality of life by reducing the side effects associated with particular medications. 

Are there risks in using neuromodulation?

Migraine devices and neuromodulation are generally safe. However, risky incidents occur. Often, they are non-life-threatening. The main risks are:

• Treatment failure: The device may not work, especially where you have a wrong diagnosis.

• Nearby tissues may be injured when you are getting implants.

• The insertion site may get infected.

• Puncturing of sensitive tissues in areas such as the spinal cord may worsen headaches.

Is neuromodulation effective?

Neuromodulation alleviates and lessens pain while saving you the side effects of medication. Most over-the-counter and prescription drugs for migraines cause sedation and brain fog.

Given the uniqueness of migraines, get your doctor's advice before using a particular migraine device. The less-invasive nature of the intervention allows you to test its effectiveness before ditching medications for neuromodulation. You will be able to select the method that best improves your quality of life. 

Neuromodulation implants are reversible, allowing you to resume medication if the device fails to meet your expectations.

Who is best suited for this type of treatment?

Your doctor will advise the best migraine device for you and if they’re appropriate in your case. 

Do not use migraine devices if you:

• Have metallic devices and particular electronics in your head

• Don’t know the cause of your migraines

• Have an implanted or wearable defibrillator

• Have a pacemaker for your heart

• Are under 18 or over 65 years old

How can I start neuromodulation treatment?

Once diagnosed, your doctor will recommend a suitable treatment option. The need for neuromodulation is case-dependent. You should only use neuromodulation to relieve migraines following a doctor's approval. Visit a physician to learn the correct techniques.

In the case of preventive neuromodulation, use your migraine device if you expect a migraine. For acute treatment, turn on the device every time you get a migraine.

In the case of implants, they will automatically deposit medication into your nervous system. Your doctor will implant a pump and a catheter under the fat in your back.

Tell your doctor if the migraines persist.

The lowdown

Migraines can reduce your quality of life. While available medications are effective, they can cause problems such as brain fog and drowsiness. Neuromodulation is a promising alternative, especially with scientific advances. 

The FDA has approved gammaCore, Cefaly, and Spring TMS. Migraine devices use different techniques to relieve headache pain. Standard methods include brain stimulation, peripheral nerve stimulation, spinal cord stimulation, or spinal drug delivery systems. They all change the electrical impulses transmitted to the brain to correct abnormal nerve activity to alleviate headache pain. 

Neuromodulation requires you to be above 18 years old and not have other metallic devices implanted, such as a cardiac pacemaker. Consult your doctor before getting a migraine device.