Simple to use, with no side effects, nerve stimulation offers a valuable alternative to medication.
When it comes to headaches, drugs are not a panacea: there are almost 11 million migraine sufferers in France and nearly a third of them find no relief in the molecules offered to them. Inefficiency, unbearable side effects…, the reasons for these therapeutic impasses are numerous. Martine has found a way out: electrostimulation.
She opted for the Cefaly device. An electrode adhesive, placed at the level of the forehead, is magnetically connected to a helmet producing micro-pulses. « By applying it twenty minutes a day, I have reduced the number of attacks and their intensity, and I hardly take any more medication. », she rejoices. Effectiveness confirmed by solid scientific studies and by Professor Xavier Moisset, neurologist at Clermont-Ferrand University Hospital. « This device is actually very interesting. It does not work in all patients, but in those who are sensitive to it, it reduces the frequency and intensity of seizures by 30 %, with almost no side effects. »
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Its mode of action is well documented. The headband stimulates the trigeminal nerve above the eye sockets. It is transcutaneous nerve stimulation (TENS), high frequency and low intensity. The application of this current is a bit like rubbing a place where you have just hurt yourself. Non-painful information is sent to the brain, which has the effect of closing access to the pain system. This is the “gate” effect. Added to this is the stimulation of the production of pain-relieving neuromediators, such as endorphins, which allow a lasting effect. Ease of use is another advantage of this device which can be purchased without a prescription. Its weak point is its price: more than 340 euros not covered by Social Security.
Alternative devices
Luckily, there are effective but less expensive alternatives, according to Professor Moisset, in particular the Qalm helmet. Another solution is to favor TENS with self-adhesive mobile electrodes connected to a box. Initially developed to fight against neuropathic pain, these devices can be diverted from their use to treat migraines. Prescribed by a doctor from a pain center, they are then partially reimbursed by health insurance. Another advantage: they can be used for other pains, tension headaches in particular. The electrodes must then be applied to the cervical level, on the trapezius. The effect is triple with muscle relaxation, gate effect and secretion of endorphins. « These devices work well, but they are more difficult to use than electrostimulation headbands, says Professor Moisset. Initially, their use requires being accompanied by a competent doctor or physiotherapist. »
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Cluster headache, on the other hand, is rarely relieved by these painkiller TENS. But for some patients resistant to all drug treatments, it is possible to resort to a much more extreme and invasive form of electrostimulation, the surgical implantation of electrodes in the greater occipital. By stimulating this nerve, we can calm these terribly painful headaches. 80% of the fifty or so patients treated each year have found relief.
Cuff electrodes
Already marketed in the United States, the Nerivio is an original device in the world of electrostimulation. With this system, which works very well according to neurologist Xavier Moisset, « you can break a migraine attack by stimulating the arm ». You attach an armband with electrodes to your biceps for 30 to 45 minutes at the start of the attack. An application on your smartphone triggers stimulating stimulation of sensory fibers that send an inhibiting message to the cerebral center of pain. 70% of users would be relieved within two hours.