Headache pain is generally divided into four separate types: migraines, cluster-type headaches, tension-type headaches, and secondary headaches (as a result of another condition or as a side effect of treatment). Each of these can be severe enough to impact daily life, and each of them can benefit from a treatment called neuromodulation for head pain.
What is neuromodulation?
Neuromodulation can be a biological process in which the body emits chemicals that regulate neural activity (e.g., serotonin, the “feel good” hormone), but in some cases an interventional form of neuromodulation is needed.
Surgical neuromodulation uses devices implanted along the spine, in the skull, or near a group of pain-causing nerves that then emit mild electrical pulses to disrupt the pain signals. One example of this spinal cord stimulation.
With spinal cord stimulation (SCS), electrodes are positioned along the spine near the nerves that are the source of pain. A mild electrical impulse is then delivered to interfere with the body’s pain signaling. This interrupts their path to the brain and offering pain relief. This is called neuromodulation in that the pain signals to the brain are interrupted, the neural circuit broken.
How does neuromodulation for head pain work?
This neural disruption can be enacted directly in the brain itself with deep brain stimulation. Electrodes are implanted in the brain areas that receive pain signals. This blocks the signals or corrects them to not signal pain. This technique has been used in the hypothalamus, the region from which tension-type and cluster headaches seem to stem. It lends credence to the idea that these types of headaches are a result of sleep disorders or disturbances.
This technique may also work to help with cluster and nasal headaches associated with the sphenopalatine ganglion (SPG). 68% of patients in a clinical trial found relief from pain when a microstimulator was implanted in this nerve, but the duration of pain relief is still uncertain, and the risk at this time may outweigh the benefits. Patients may lose sensation and experience sensory disturbances as a result of treatment, and there is the risk of infection and tissue damage during implantation.
TENS unit therapy
Less invasive forms of neuromodulation are called transcranial stimulation. The most common form of this is transcutaneous electrical nerve stimulation (TENS). During transcutaneous nerve stimulation, doctors place a cap or pads on the patient’s skull. They then deliver mild electrical current across the vagus nerve to trigger the release of pain-blocking signals. This has been a promising treatment for pain associated with migraine and cluster headaches.
Transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) are two other less-invasive neuromodulation techniques. The first has been used with success in the treatment of chronic migraines and the second for episodic migraines. Both have very limited side effects and are promising treatments, but more research in larger clinical trials needs to be completed to truly judge their effectiveness.
Neuromodulation is a promising weapon in the arsenal against headache pain. Have you tried neuromodulation for head pain?