Arm-Worn Electrical Device Could Treat Migraine as Effectively as Medication
Introduction
Today I came across a new study by Yarnitsky et al [1] which shows promising results for treating migraine using an electronic stimulation device worn on the arm.
As someone who suffers from episodic migraines I am always on the lookout for new treatments.
Although a lot of drug based treatments are available, they have their own unique side effects which can be problematic.
For example I use Sumatriptan (thought to work by constricting blood vessels in the brain) - unfortunately this can cause constriction of blood vessels in other parts of the body which can be uncomfortable and in certain cases dangerous.
A safe, tolerable, non-drug based alternative would certainly be very useful.
How is this different?
(N.B. Image is of TENS machine electrodes from Thinkstock. I wasn't able to find images of the actual device used in time for the post.)
Previous research along similar lines uses devices that need to be more precisely located in the face or head region.
This makes them less convenient to use.
The device used here is called Nerivio Migra:
[It] consists of a pair of rubber electrodes mounted on an armband with a power source, controlled by the patient’s smartphone, via a custom-made application.
Patients are easily able to apply it to one of their arms without any assistance and it is easy to hide.
Methods
The study asked patients to use the Nerivio Migra device within 20 minutes of onset of a migraine.
Previous research has indicated that earlier treatment (when the pain level is lower) tends to be more effective.
The devices were designed to give patients either active treatment or an inactive "sham" treatment to act as a placebo.
A number of different types of information were collected including people's level of pain.
Results
The devices worked very well - 64% of patients with active treatment had a greater than 50% reduction in pain.
This compares to a rate of 26% for placebo.
The extent of pain relief was almost identical to that for triptan medications (the type which I use).
As the authors state:
Interestingly, our extent of pain relief is almost identical to that reported for triptans: 59% transition from severe/moderate to mild/no pain for triptans parallels the 58% reported here; 29% and 30% are the respective numbers for transition to no pain.
This suggests that this type of treatment could be used as an alternative to conventional medical treatments.
Equally importantly the devices were well tolerated. Most people found the stimulation to be pleasant.
Patients were asked to rate the treatment for how much of a burden it was, the mean score (2.5) was between "neutral" and "not at all".
On rating "ease of use" the mean score fell between "easy and very easy".
How does it work?
The short answer is that we don't fully understand.
The authors suggest this treatment utilises an effect known as Conditioned Pain Modulation (CPM).
According to Nir and Yarnitsky [2] :
"[CPM] has been described using various terms, including ‘diffuse noxious inhibitory controls’, ‘counterirritation’, and ‘heterotopic noxious counter-stimulation’."
According to them previous research has suggested that one form of pain (noxious stimulus) can actually inhibit another form of pain.
This study suggests that reducing the intensity of the painful stimulus to below the pain threshold still works in inhibiting the pain.
Studies on CPM suggest that the pain relief relates to local, spinal cord and brain effects (involving a variety of regions).
The specifics of this are still a matter of debate although it appears the brainstem plays an important role.
I suspect the mechanism might well be the same for CPM, acupuncture and also for the natural, reflexive response of massaging an injured body part.
Problems
As is often the case this was a relatively small study.
71 patients comprised the final sample (with a total of 299 treatments).
I have described many times before how small sample sizes can reduce the statistical strength of results.
There was also a gender imbalance with significantly more women (69) than men (17) - this might reduce the validity of the results in men.
This is a double blind study but as the authors themselves point out, it can be difficult to blind people fully to sham treatment.
They will likely be able to feel the difference between it and active treatment.
This was suggested by the fact that those receiving sham were less likely to complete the full (20 minutes of) treatment.
Perhaps they realised they were receiving the sham and ended it early because they didn't expect any benefit.
Conclusion
This is certainly a fascinating preliminary study.
It suggests that a simple form of electrical stimulation may be able to treat migraines as effectively as one of the leading class of drugs (triptans) without the potentially serious side effects.
It also seems to be better tolerated, less obtrusive (arm vs head) and easier to apply and use than alternative methods that work using similar principles.
I would feel much more comfortable wearing an arm worn device (vs head worn) if I was at work or in public.
The authors even point out that it can easily be hidden under a sleeve.
As is often the case this is early research and I do hope that this can be confirmed with larger studies.
If that happens then we could end up with a safer and better tolerated migraine treatment which would be of great use to those of us who suffer with this problem.
What do you think?
As always let me know what you think in the comments.
Thank you for reading
References
Yarnitsky, David, Lana Volokh, Alon Ironi, Boaz Weller, Merav Shor, Alla Shifrin, and Yelena Granovsky. 2017. “Nonpainful Remote Electrical Stimulation Alleviates Episodic Migraine Pain.” Neurology, March. doi:10.1212/WNL.0000000000003760.
Nir, Rony-Reuven, and David Yarnitsky. 2015. “Conditioned Pain Modulation.” Current Opinion in Supportive and Palliative Care 9 (2): 131–37.
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Electro-medicine is the future.
Sadly, it is also the past, but a past that has been violently suppressed by the medical establishment, the pharmaceutical companies, and their stooge agents in the FDA and the US federal government.
One of the earliest examples of this is the destruction of the life-work of Royal Raymond Rife, and more recently the suppression of a technology developed by Bob Beck, a simple electrical device to cleanse pathogens from the human bloodstream.
😄😇😄
Interesting. Well hopefully this will take off - I would much rather use this than the medications.
Agreed! ;)
Well, I suffer from headaches badly now that debilitate me so that would be helpful for sure. If it worked for me etc as per the other info in here. I don't like putting chemicals into my body.
the study for sure was not balanced and needs 50/50 for men and women, why they would even bother to skew the numbers this way, God knows why
do you think women have higher overall pain thresholds, given the whole deal with childbirthing and all that? I have always thought so.
I think it may be because more women suffer from migraines although I may be misrembering that.
I think women complain less for cultural reasons. Genetics and cultural conditioning are more important than gender in this case IMO.
Thank you for sharing this information about migraine treatment without medicine. Hope this is going to be a breakthrough.
Me too! I hope they continue to research it and assuming there aren't any problems that come up they can get it out as soon as possible.
I worked with a guy in a Los Angeles nightclub.., and when a migraine hit, he would have to go lie down in the managers office with all the lights off... It was terrible, he was completely incapacitated. Sounds like a pretty handy device...
Yes absolutely. That is exactly how it is with me too. I have to go lie down in the dark until it passes. It is hard to say what is worse the pain or the nausea.
Very interesting. The technology of this century never ceases to amaze.
I would still advise that one uses meditation to combat migraines before this device. Simply focus on the pain until it is under your control, and then will it away.
I think meditation would probably not help during the actual attack because the pain makes it hard to focus (unless you are a master meditator) but I do think in the early stages it might help and regular meditation might help to prevent it because there is a definite stress relationship. Thanks for the reminder - next time I feel one coming on I will try the meditation.
I understand why one would think this way, but actually, the more intense the pain the easier the meditation becomes.
Meditation is all about focusing on one thing, and one thing alone. This means that it is easier to focus on the pain if it is powerful enough to distract you from everything else.
I don't think it would be easy for a beginner, but for someone who has experience with meditation, it would certainly be easier than a subtle pain that does no service to distracting one from their thoughts.
Interesting. I think for someone like me it is still not something I would be able to do but maybe with time.
My wife and a lot of her family deal with migraines.
medical studies show a great positive effect of psylocybe mushroom in extreme cluster headache attacks.
http://clusterheadacheinfo.wdfiles.com/local--files/file%3Aclusterheadachesresponsivetopsilocybin-halpernssewellpo/ClusterheadachesResponsiveToPsilocybin_HalpernSSewellPope.pdf
Yeah, don't need to chance imprisonment and asset forfeiture for using something like that though.
It´s really sad when the real medicine is forbidden and chemical toxic substances are forced upon us and our children . . . . 95% sucess rate is what chemical pharma can only dream of relating to cluster headache.
These substance are also very useful for treating and in some cases (allegedly) curing depression which interestingly has an association with migraine and cluster headaches too (unless I'm mistaken). Hopefully we will get change because the research as with cannabis extracts is growing all the time (no pun intended).
I believe all drugs should be legal. If you want to create programs for people who need help voluntarily then go for it, you'll have my support. If you want to by force prohibit people from doing what they want with their own body, and being responsible for the consequences of their choice then I am very much against that.
As with any drug there can be some real negative effects. Yet any substance can be abused, and that is the responsibility of the person.
LSD...
I had lots of friends that did LSD. I didn't I am weird enough without needing any assistance.
I had one friend out of many though that had a very bad reaction to it after years of doing it.
He was a smart guy, and had lots of girls fawning after him, calling him Tall Dark and Handsome, he played bass guitar. I'd chat with him and hang out with him sometimes.
I hadn't seen him for a couple of years once I was in college and I happened to go to this party. He walked in, his hair was all over, he was dirty, his teeth were black, and he sat on a couch and he just stared blankly ahead of him...
I asked "what happened to him?"
I was told "He ate an entire sheet of acid and has been like that every sense".
He is the only friend I have that this happened to. My parents are hippies and were around when it was popular. They had a few friends fried by LSD in the early days, but for the most part it doesn't seem to have such an effect.
Due to the illegal nature the safety of batches of LSD cannot be verified, so it could be bad batch, or simply overdose which is likely the case with my friend.
Years after that I'd see him on the side of the road with a bicycle somewhere staring up at the sky... I'd look and not see anything there.
It really messed him up, but eating a sheet of acid was a pretty dumb thing to do if that is indeed what he did.
thanks for the reply. well said! >>...the safety of batches of LSD cannot be verified >> thats why I said "No thanks" a tousand times on festivals. I worked as visual artist on many of these psychodelic open air like BOOM 4 times, and similar all over the globe. I saw a lot of really bad messed up people too, not my direct friends but just really "lost souls" unable to find their homebase - no passport - no tshirt - no nothing + completely tilt.
BUT i found a medical article maybe to add here on the headache topic. http://journals.sagepub.com/doi/full/10.1177/0333102410363490 Have a great day!
I she taking medication for it?
Very rarely. She used to have them pretty frequently. Now it is not nearly as often. Years ago she had them easily once a week, and they could be debilitating.
I've only had one in my life that was even close to bad. When parts of my vision disappeared and I was moving an invoice I was reading around so I could see what was under the blank spots in my vision.
I told my wife... she gave me something and said I was having a migraine and it knocked me on my ass. I woke up many hours later groggy but never having experienced the severe pains I see her go through.
She'd had it temporarily paralyze parts of her body, and all sorts of things like that.
I do know trying to keep stress down, and working on not getting as worked up over certain things helps.
Also limiting exposure to things that trigger it like striped, checkered, polka dot clothes, flashing lights like strobe light, sudden flashes of sunlight through the window into her eyes, etc.
These days it is usually getting flashed by bright sunlight reflected off of something that triggers hers.
That must be scary if you don't normally get them!
Wow that is pretty bad and worrying too.
That happens to me too - particularly if I am driving and the sun is low on the horizon - I think it is a common trigger.
Mine was not scary, because I didn't realize what was going on and it hadn't started hurting yet.
I just told her I had to move an invoice around to read the total because there were like blank spots.
She said I was having a migraine and that stuff usually happens before the pain. She gave me something and it knocked me on my ass.
So I never did feel the pain.
It wasn't that scary. Some of them that have happened to her have been pretty scary. Like I said she doesn't have them nearly as often now.
You are braver than me! I would convince myself it was a retinal detachment or a stroke!
I think it changes with age - I used to get them a lot more as a kid and a teenager so I wonder if there is some hormonal component.