Nerve Stimulation Therapy Alleviates Pain For Chronic Headache

A novel therapy using a miniature nerve stimulator instead of medication for the treatment of profoundly disabling headache disorders improved the experience of pain by 80-95 percent, according to a new study from the University of California, San Francisco and the National Hospital for Neurology and Neurosurgery in London.

Up to 35 million Americans suffer migraine and other forms of headache, according to the American Academy of Neurology.

“We need a range of treatments to offer patients whose lives are taken over by debilitating headaches,” said Peter J. Goadsby, MD, PhD, lead author, neurologist and director of the UCSF Headache Center. “It’s quite exciting to think about how technology will advance in the next five years to provide remarkable devices for the treatment of headache. Preventive approaches like these will completely change the landscape of headache treatment.”

The device, called a bion, is a rechargeable battery-powered electrode, similar in size to a matchstick. When implanted near the occipital nerve in the back of the neck, it alleviates pain by generating pulses that the nerve receives. The bion can be turned on or off via an external wireless remote control. Previous versions of the bion have been used in pain management for osteoarthritis and in the treatment of dislocated joints for patients recovering from stroke.

The study measured the effectiveness of nerve stimulation in six patients aged 37 to 64 with hemicrania continua, a rare headache disorder defined by the International Headache Society as a form of chronic daily headache in which patients have 15 days or more of headache per month.

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Headaches.

A headache (cephalalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. It ranks amongst the most common local pain complaints and may be frequent for many people.

The vast majority of headaches are benign and self-limiting. Common causes are tension, migraine, eye strain, dehydration, low blood sugar, hypermastication and sinusitis. Much rarer are headaches due to life-threatening conditions such as meningitis, encephalitis, cerebral aneurysms, extremely high blood pressure, and brain tumors.

When the headache occurs in conjunction with a head injury the cause is usually quite evident. A large percentage of headaches among women are caused by ever-fluctuating estrogen during menstrual years. This can occur prior to, or even during midcycle menstruation.

Treatment of an uncomplicated headache is usually symptomatic with over-the-counter painkillers such as aspirin, paracetamol (acetaminophen), or ibuprofen, although some specific forms of headaches (e.g., migraines) may demand other, more suitable treatment. It may be possible to relate the occurrence of a headache to other particular triggers (such as stress or particular foods), which can then be avoided.

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Headaches Causes.

Headaches have a wide variety of causes, ranging from eyestrain to inflammation of the sinus cavities to life-threatening conditions such as encephalitis, , and cerebral aneurysms. When the headache occurs in conjunction with a head injury the cause is usually quite evident; however, many causes of headaches are more elusive.

The most common type of headache is a tension headache. Some people experience headaches when they are hungry or dehydrated. Traditional theories about headaches link tension-type headaches to muscle contraction, and migraine and cluster headaches to blood vessel dilation (swelling). Pain-sensitive structures in the head include blood vessel walls, membranous coverings of the brain, and scalp and neck muscles. Brain tissue itself has no sensitivity to pain.

Therefore, headaches may result from contraction of the muscles of the scalp, face or neck; dilation of the blood vessels in the head; or brain swelling that stretches the brain's coverings. Involvement of specific nerves of the face and head may also cause characteristic headaches. Sinus inflammation is a common cause of headache. Keeping a headache diary may help link headaches to stressful occurrences, menstrual phases, food triggers, or medication.

Tension headaches are due to contraction (tightness) of the muscles in your shoulders, neck, scalp, and jaw. They are often related to , depression, or anxiety. Overworking, not getting enough sleep, missing meals, and using alcohol or street can make you more susceptible to headaches. Foods that can trigger a headache include chocolate, cheese, and monosodium glutamate (MSG), a flavor enhancer. People who drink caffeine can have headaches when they don't get their usual daily amount.

Other common reasons lead to a tension headache include performing an activity that causes you to hold your head in one position for a long time (like using a computer, microscope, or typewriter), sleeping in a cold room or an abnormal position, overexerting yourself, clenching your jaw or grinding your .

Tension headaches tend to be on both sides of your head. They often start at the back of your head and spread forward. The pain may feel dull or squeezing, even like a tight band or vice around your head. The muscle tension often begins in your shoulders, neck, or jaw before spreading to your head.

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Headaches Treatment.

Although there is no cure for migraines, you can often reduce and possibly prevent some migraines. Drugs are available to prevent or treat migraines. There is some evidence that taking aspirin along with a drug that helps with nausea, such as metoclopramide (for example, Reglan), may help reduce migraine symptoms.

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You may also reduce the number of migraines you have by identifying and avoiding triggers that lead to migraines, such as drinking red wine or getting too much or too little sleep.

Initial treatment

At first you may use pain relievers that you can buy without a prescription, such as acetaminophen (for example, Tylenol), and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen sodium, to reduce migraine symptoms. Some doctors recommend that you first try an NSAID to see whether it reduces pain before trying abortive or preventive drugs, which may have more side effects.

Initial treatment depends on how severe your migraine attacks are and how often they occur, but usually includes drugs to stop a headache (abortive) or drugs to prevent a headache (preventive), along with treatments that may reduce stress.

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