Migraines are more than just headaches – they can be debilitating and come with intense pain, nausea, and sensitivity to light. This condition affects millions of people across the U.S., and if you’re one of those people, you’re likely familiar with the constant search for relief. While headache pain medications are often used to treat migraines, they don’t always offer long-lasting results.
For those experiencing chronic migraines, Transcranial Magnetic Stimulation (TMS) therapy offers a promising alternative to traditional treatments. This innovative, FDA-approved therapy uses magnetic pulses to target specific regions of the brain, helping reduce the frequency and intensity of migraine episodes. TMS has shown great potential in helping those with chronic migraines, especially when other treatments haven’t worked.
In this article, we’ll share what you need to know about TMS for migraines, including how it works, its benefits, effectiveness, and precautions.
What are migraines?
A migraine is a neurological condition that causes intense, throbbing head pain. Migraines are typically accompanied by a range of symptoms, including nausea, vomiting, and extreme sensitivity to light and sound. The pain can last anywhere from hours to several days, making it difficult or impossible for a person to engage in everyday activities.
Types of migraines
There are various types of migraines, including:
- Migraine with aura (classic migraine): This type includes an ‘aura’ phase, where a person experiences visual or sensory disturbances before the migraine headache begins.
- Migraine without aura (common migraine): This is the most common type of migraine, where no aura is experienced.
- Chronic migraine: This is where a person experiences 15 or more migraine days per month for several months.
- Hemiplegic migraine: This is a rare type of migraine that causes temporary paralysis or weakness on one side of the body.
- Menstrual migraine: This migraine is linked to the menstrual cycle, typically occurring around the time of menstruation.
- Silent migraine (migraine without headache): This type of migraine doesn’t involve the typical head pain but still causes other symptoms like nausea or visual disturbances.
- Retinal migraine (ocular migraine): This type of migraine causes temporary vision loss in one eye.
- Status migrainosus: A prolonged migraine that lasts more than 72 hours and can lead to severe dehydration and other issues.
Migraine symptoms
Migraines typically progress through four stages: prodome, aura, attack, and post-drome. Not every person experiences all these stages, and symptoms can vary from one migraine to another.
Below is a closer look at each phase and its associated symptoms.
Prodrome
The prodrome phase occurs 1-2 days before a migraine attack. During this stage, you might notice subtle changes in your body that signal a migraine is coming.
Prodrome symptoms include:
- Constipation
- Mood changes
- Food cravings
- Neck stiffness
- Increased urination
- Fluid retention
- Frequent yawning.
Aura
Not everyone experiences an aura, but for those that do, it typically comes just before or during the headache phase. Auras are reversible neurological symptoms that begin gradually and can last anywhere between a few minutes up to an hour.
Examples of aura include:
- Visual disturbances (e.g. seeing shapes, flashing lights, or blind spots)
- Vision loss
- Pins and needles in the arm or leg
- Weakness or numbness in the face or one side of the body
- Difficulty speaking.
Migraine attack
The headache phase of the migraine is usually the most intense and typically lasts between 4 to 72 hours if untreated. Symptoms of a migraine attack include:
- Throbbing or pulsing pain, usually on one side of the head
- Sensitivity to light, sound, smell, and sometimes touch
- Nausea and vomiting.
Post-drome
After the migraine attack, some people experience a post-drome phase, sometimes known as a ‘migraine hangover’. This phase can last anywhere from a few hours up to 48 hours. Symptoms include:
- Fatigue
- Stiff neck
- Sensitivity to light and sound
- Difficulty concentrating
- Nausea
- Dizziness.
It’s important to remember that each migraine experience is different, and these phases only give a general overview of migraine symptoms.
What is TMS therapy for migraines?
Transcranial Magnetic Stimulation (TMS) therapy is a non-invasive treatment that uses electromagnetic pulses to stimulate nerve cells in the brain. For migraine sufferers, TMS targets the brain’s outer layer – the cortex – to help regulate abnormal neural activity. Over a number of treatments, TMS can help reduce the frequency and severity of migraine episodes, making it a promising option for those who haven’t found relief with traditional treatments.
TMS therapy for migraines is administered in a clinical setting using a personalized approach. Unlike many other migraine treatments, TMS works without the need for drugs, injections or surgery. There’s also no need for anesthesia or sedation, meaning patients can immediately return to normal activities after treatment.
TMS therapy is already widely recognized for its effectiveness in treating major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and smoking cessation. It has also been FDA-approved for migraines, and ongoing research continues to explore its potential for other neurological and psychological conditions, including post-traumatic stress disorder (PTSD), bipolar disorder, and chronic pain.
If you experience frequent migraines that disrupt daily life, TMS therapy offers an alternative approach that is safe, well-tolerated, and doesn’t rely on medication.
Note: TMS is sometimes referred to as repetitive transcranial magnetic stimulation (rTMS) due to the repetitive nature of the magnetic pulses.
See: Who Qualifies for TMS Therapy? (TMS Requirements)
Can TMS treat migraines?
Migraines can be debilitating, especially for those with chronic migraine (defined as having 15 or more days of symptoms each month). This can severely impact daily life, making it difficult to work, focus, or enjoy regular activities. Research suggests that TMS can help reduce the frequency, duration, and intensity of migraine attacks.
In one 2021 study, TMS was found to lessen the number of migraine episodes and reduce the severity of migraine pain. Another study in 2022 indicated that TMS could decrease the number of migraine days by up to eight per month, providing significant relief for those suffering from frequent episodes.
Importantly, TMS has been shown to be effective for migraines with and without aura, and for people of all ages, making it a versatile treatment option for many migraine patients.
Read More: How Successful is TMS Therapy?
What to expect from a TMS session
If you’re considering TMS therapy, here’s what you can expect from a typical session.
Before the session
TMS doesn’t require any preparation beforehand, however before treatment you may be asked to remove any metallic jewelry or accessories (such as glasses with metal frames). This is a precaution to ensure that no magnetic materials interfere with treatment.
You will be seated in a comfortable chair by your TMS technician and they’ll answer any questions or concerns you may have before treatment. TMS therapy uses a specialized device that contains a magnetic coil housed inside a nonmagnetic casing. Depending on the type of device used, you may be asked to wear a helmet containing the coil or the magnet may be positioned near your head using an adjustable arm.
During the session
Once you’re seated comfortably, your technician will give you earplugs or another form of hearing protection. This is because the magnet produces clicking sounds similar to an MRI machine, which can be loud enough to require protection.
The TMS technician will then position the magnetic coil over a specific area of your head. The placement depends on the condition being treated. Your first TMS session will involve ‘brain mapping’, which is where the TMS technician finds the optimal target area and intensity of magnetic pulses to make the treatment effective and comfortable.
See More: What is Brain Mapping for Transcranial Magnetic Stimulation (TMS)?
When the session begins, you might feel a tapping sensation on your scalp as the magnetic pulses activate nerve cells in your brain. The strength of the pulses will gradually increase, and you may notice involuntary twitches or slight movements in your hands or thumbs. This response is normal and helps the technician ensure the correct level of stimulation is being given.
TMS treatment consists of repeated pulses delivered in a specific pattern. You’ll hear clicking noises as the magnet turns on and off, and there may be short pauses between pulses to prevent the device from overheating. Typical TMS sessions can range from 30 – 60 minutes.
After the session
TMS doesn’t require any recovery time. You’ll be awake and alert throughout the whole session and can drive yourself home or return to your daily activities immediately afterwards. Some people experience mild side effects, such as scalp discomfort, but these typically resolve quickly on their own.
Follow-up sessions
TMS therapy typically involves multiple sessions administered over several weeks. Future sessions will be similar to the first, although your provider may adjust the settings based on how you responded to the treatment. The goal is to fine-tune the stimulation to maximize benefits while minimizing any discomfort.
For those who prefer a more condensed treatment plan, accelerated TMS therapy involves administering the therapy several times per day over just two weeks. This can provide faster results while also reducing the total time needed for treatment.
Read more about accelerated TMS here: Accelerated TMS vs. Traditional TMS: Which One Makes Sense for You?
Benefits of TMS for migraines
TMS offers several benefits as a migraine treatment, including:
Non-invasive and convenient
Unlike some migraine treatments, TMS doesn’t require surgery, injections, or anesthesia. Each session is quick and painless, and you can resume your daily activities immediately after treatment. This makes TMS a practical option for those wanting to manage migraine symptoms without disrupting their daily routine.
Safe with minimal side effects
TMS is generally well-tolerated, with the most common side effects being mild scalp discomfort or a temporary headache. Serious side effects are extremely rare. Compared to some medications that come with significant side effects, TMS can provide a safer alternative for migraine management.
Effective
Studies have shown that TMS can reduce the frequency, severity, and duration of migraine episodes. Research suggests that some individuals experience up to eight fewer migraines per month after regular TMS sessions, and that the therapy is effective for migraines with and without aura. Its benefits also extend across different age groups.
Complementary to other treatments
TMS can be used alongside other migraine management strategies, including medication, migraine prevention strategies, and mental health therapies. This means patients can tailor treatment plans to achieve the best possible outcomes.
Personalization
Migraine patterns and severity vary from person to person, and TMS therapy can be personalized for each individual. Your TMS technician will find the best placement for the magnetic pulses, frequency of treatments, and intensity of stimulation to best suit your needs.
Keep Reading: TMS vs. ECT: Which is better?
TMS side effects
While TMS is mostly well-tolerated, it can have side effects. Most are mild and temporary, typically resolving on their own as treatment progresses and the body adjusts to the therapy.
Common side effects of TMS therapy include:
- Tingling or twitching of facial muscles
- Scalp discomfort
- Dizziness or lightheadedness
- Neck pain
- Mild headaches.
The most serious risk of TMS therapy is a seizure, however this is extremely rare with a risk of less than 0.01% per session, or less than 1 in 10,000. Providers carefully screen for the risk of seizure before starting treatment.
If you have any questions about TMS side effects, don’t hesitate to contact our team. We’ll be happy to discuss the treatment with you.
Is TMS therapy right for me?
TMS can be a valuable treatment option for many migraine sufferers, but it’s not the right choice for everyone. There are certain situations where TMS therapy may not be recommended.
Who should avoid TMS therapy?
TMS therapy may not be suitable for you if you:
- Have a history of seizures or epilepsy
- Are pregnant or breastfeeding
- Have experienced brain injuries or conditions (e.g. traumatic brain injury or tumours)
- Are using stimulant medications.
Since TMS uses magnetic pulses, it can interact with metal devices or implants in the body. This means you shouldn’t undergo TMS if you have:
- Cochlear implants
- Deep brain simulators
- Aneurysm clips or coils
- Implanted electrodes or stents
- Shrapnel or bullet fragments
- Vagus nerve stimulators.
Dental fillings and braces are completely safe with TMS, so there’s no need to worry about these types of metal in your body.
If you’re not sure whether TMS is suitable for you, our team at BestMind Behavioral Health will be happy to help. We carefully screen each of our patients prior to a TMS therapy and can help you understand whether this migraine treatment is a good fit for you.
Explore TMS therapy for migraines
If you experience chronic migraines and haven’t found relief from traditional treatment options, TMS therapy may provide the solution you’re looking for.
At BestMind Behavioral Health, we offer TMS therapy at our comfortable and discreet clinics in Colorado, Oregon, and Washington. Our compassionate team is dedicated to helping you find relief from migraines and improve your quality of life. We accept a variety of healthcare plans and are here to guide you on your journey to better well-being.
Reach out today to learn more about how TMS can help you manage migraines and to see if it’s the right treatment for you.
