A “headache machine” refers to various non-invasive medical devices designed to alleviate headache symptoms. These devices offer a non-pharmacological approach to managing pain, used for acute treatment and prevention of various headache types. They typically interact with the nervous system to modify pain signals, providing an alternative or complementary option to traditional medications.
Identifying Headache Relief Devices
Several types of non-invasive devices are available for headache relief, differing in their application and targeted areas. External trigeminal nerve stimulation (eTNS) devices, such as Cefaly, are applied to the forehead with electrodes to stimulate the supraorbital and supratrochlear nerves. Remote electrical neuromodulation (REN) devices, like Nerivio, are wireless and worn on the upper arm, delivering electrical pulses to peripheral nerves.
Non-invasive vagus nerve stimulators (nVNS), such as gammaCore, are handheld and placed on the side of the neck to stimulate the vagus nerve. Transcranial magnetic stimulation (TMS) devices, like sTMS mini, are positioned at the back of the head and use magnetic pulses. Some devices combine stimulation of multiple nerves, such as systems that target both the occipital and supraorbital nerves, which may be implanted. Biofeedback devices are distinct in their approach, typically involving sensors that monitor physiological responses.
The Science Behind Their Function
These devices primarily work through neuromodulation, a process that modifies nerve activity using electrical impulses or magnetic fields. External trigeminal nerve stimulation (eTNS) devices stimulate branches of the trigeminal nerve in the forehead, which plays a significant role in migraine pathophysiology. This stimulation is thought to desensitize the nerve and may also affect metabolic activity in brain areas that process pain. The electrical impulses, often biphasic rectangular impulses, can be delivered at different frequencies depending on whether the aim is prevention (e.g., 60 Hz) or acute treatment (e.g., 100 Hz).
Remote electrical neuromodulation (REN) devices operate by stimulating peripheral nerves in the upper arm, which can induce conditioned pain modulation. This is an internal pain relief mechanism where stimulation in one body region can inhibit pain in a remote area, such as the head. The device delivers a symmetrical, biphasic, square electrical signal with a modulated frequency of 100–120 Hz and a pulse width of 400 μs, with an output current up to 40 mA, which the user can adjust.
Non-invasive vagus nerve stimulators target the vagus nerve in the neck, which is involved in regulating the parasympathetic nervous system and pain signals. Transcranial magnetic stimulation (TMS) devices use electromagnetic pulses to stimulate nerve cells in the brain’s cortex. These magnetic fields create a small electrical current that is believed to disrupt abnormal brain activity associated with migraines and alter how pain is processed. Biofeedback devices, unlike neuromodulation, do not directly stimulate nerves but rather provide real-time information about physiological responses like muscle tension or skin temperature. This allows individuals to learn to consciously control these responses, thereby reducing headache intensity and frequency.
Important Considerations for Device Use
Headache relief devices are indicated for various types of headaches, including migraines and tension headaches. Some eTNS devices are cleared for acute and preventive migraine treatment in adults, with daily preventive sessions lasting around 20 minutes and acute treatment sessions up to an hour. REN devices are cleared for acute migraine treatment in individuals 12 years and older, with typical sessions lasting 45 minutes, ideally initiated within one hour of headache onset.
Potential minor side effects can occur. For eTNS devices, users might experience stimulation-induced tingling, sleepiness, or a mild headache. REN devices may cause tingling, warmth, or slight numbness in the arm. TMS treatments can sometimes result in mild, transient headaches, but these often diminish with continued use. Biofeedback therapy is generally considered safe, with no known serious side effects, though some people might experience discomfort from the sensors.
Always consult a healthcare professional before using any headache relief device. A doctor can provide proper diagnosis, recommend the most suitable device, and discuss potential contraindications. For example, these devices should not be used by pregnant individuals or those with implantable devices like pacemakers, cancer, epilepsy, or certain heart conditions.