Understanding the US Migraine Procedure
The US Migraine Procedure is a revolutionary peripheral nerve stimulation treatment designed to alleviate chronic, severe migraines, headaches, and other types of head pain. This minimally invasive procedure involves implanting a neurostimulator device under the skin to target specific nerves associated with head pain. By delivering mild electrical impulses to these nerves, the US Migraine Procedure disrupts pain signals, reducing the frequency and intensity of head pain and often reducing the symptoms associated with migraines.
The procedure targets nerves in the supraorbital and occipital regions of the head, which are known to play a significant role in head pain. Small electrodes are implanted beneath the skin to deliver electrical impulses to these nerves, providing immediate relief from head pain. Patients can control the device’s activation and intensity using an app on a phone, allowing for personalized pain management.
The mechanism involves a small, implantable battery that generates mild electromagnetic fields, emitting electrical pulses to the superficial nerves in the forehead and back of the head. This action not only alleviates pain but also stimulates deep brain centers involved in headache genesis, effectively preventing or stopping head pain.
The US Migraine Procedure is recommended for patients who have frequent, severe head pain that has not responded to other treatments. We generally ask that two criteria be met:
- You have 10 or more head pain days per month, and
- You have tried at least 6 months of medical management (head pain or migraine medications), and nothing is working.
The US Migraine Procedure is not exclusively for migraine sufferers; anyone with persistent, intense head pain seeking relief may benefit. Our specialists evaluate each case to determine the procedure’s suitability, considering factors like your past treatment responses and specific head pain characteristics.
The US Migraine Procedure’s implantable device is fully FDA approved for types of chronic pain most commonly over the neck and back. It’s use and application for head pain is termed an “off label” application. Off-label use of medical treatments is a common practice in the United States, allowing physicians to use approved medical devices or drugs for purposes other than those specified in the FDA-approved labeling when they believe it will benefit their patients. In the case of the Migraine Procedure, decades of research and clinical experience support its effectiveness in managing chronic head pain despite not having formal FDA approval for this specific indication.
The US Migraine Procedure includes Occipital Nerve Stimulation (ONS) as a component but encompasses a more comprehensive approach involving Supraorbital Nerve Stimulation (SONS) for broader head pain coverage. It’s a combination therapy targeting both the forehead (supraorbital region) and the back of the head (occipital region).
In fact many neurologists do refer patients to us. Some of the most respected names in the field, in fact, are strong proponents of the US Migraine Procedure.
Yes, our approach empowers patients. We’re not asking anyone to “believe” in the procedure based on our say-so or the research. With the trial stimulator, patients can personally experience and assess the effectiveness of the treatment. The trial procedure is a test drive and allows each patient to make an informed decision based on their own experience and results.
Considering the Procedure
Yes, the US Migraine Procedure has shown remarkable success for many patients who have not responded well to other migraine treatments or surgeries. With our extensive experience and innovative approach, we aim to provide relief for chronic, severe head pain, regardless of past treatment outcomes. If you’ve had unsuccessful migraine surgeries in the past, we encourage you to consider the Migraine Procedure as a potential solution.
The US Migraine Procedure has been highly successful in treating almost all kinds of chronic head pain, including:
– Migraine Headaches of all types
– Chronic Migraine
– Chronic Daily Migraine
– Hemiplegic Migraine
– Migraine with or without Aura
– Hard-to-treat Migraine
– Any other Migraine Headache variation
– Headache after head or neck injury
– Cluster Headache
– Pseudotumor Cerebri (Normal Pressure Hydrocephalus; Elevated Intracranial Pressure)
– Arnold-Chiari Syndrome
– Occipital Neuralgia
– Post-herpetic Neuralgia
– Any other Face and Head Neuralgia
– Brain Aneurysm
While it’s essential to discuss the specifics of your medical condition with the doctor, in general, yes, implanted stimulators have shown significant success in patients with:
– Diabetes
– Any type of shunt, such as “VP Shunt” or spinal fluid shunt
– History of repeated Lumbar Punctures (LPs)
– Aneurysms
– Pseudotumor Cerebri (Normal Pressure Hydrocephalus)
– Seizures
– Multiple Sclerosis
– Nerve Damage
– Previous nerve surgeries
– Any form of arthritis, including Rheumatoid Arthritis
– Fibromyalgia
– Existing implanted stimulators, like spinal cord stimulators
– Heart Conditions, including pacemakers
Yes, the US Migraine Procedure is designed to address not only migraine pain but also associated symptoms, including auras. By targeting the nerves responsible for head pain, the procedure aims to interrupt the pain signals that trigger both the head pain itself and any accompanying symptoms, such as auras. With its focus on stimulating specific nerves in the head, the Migraine Procedure offers comprehensive relief for chronic, severe head pain and its associated symptoms.
There isn’t necessarily an age limit for undergoing the US Migraine Procedure. Instead, eligibility for minors is determined based on a combination of their height and weight. This personalized approach ensures that individuals of varying ages can be considered for the procedure based on their unique physical characteristics and medical history.
In addition to inventing the procedure, our specialists at US Migraine have been at the forefront of the Migraine Procedure clinical research since its inception in 1992.
Procedure Effectiveness and Comparisons
The US Migraine Procedure is tailored exclusively for patients suffering from chronic, severe head pain who have exhausted conventional treatment options. Within this subset of head pain sufferers, our success rate is an impressive 80%. This means that for every 10 patients who meet this criteria, a remarkable 8 find significant and lasting relief from chronic, severe head pain with the US Migraine Procedure.
Unlike many traditional treatments that may only manage symptoms temporarily, the US Migraine Procedure addresses the root cause of head pain by directly stimulating the nerves involved in pain generation. Its unique approach and high success rate set it apart as a promising option for those who have found little relief elsewhere.
The US Migraine Procedure is specifically considered in patients where other treatments, including head pain medications, are simply no longer effective. Our patients that respond positively to the Trial Stimulator commonly report excellent, long-term relief of their head pain and return to full normal lifestyles. Those patients often report that they are indeed no longer need typical head pain medications or that the amount needed has been markedly reduced.
Transportation and Lodging
Many of our patients travel to our facility for the US Migraine Procedure because we are renowned for our expertise in performing this procedure. With our extensive experience, we’re well-equipped to assist patients in planning their trips to Dallas, TX or Saddlebrook, NJ for treatment. Additionally, nearby hotels in Dallas offer discounted rates exclusively for our patients, ensuring a convenient and comfortable stay during their visit.
Trip 1 (Trial Procedure): Patients typically arrive in Dallas, TX or Saddlebrook, NJ the day before their trial procedure and depart the day of their end-of-trial appointment. If a patient has a trial on Monday, their end-of-trial appointment is on Thursday. Likewise, if a patient has their trial procedure on Tuesday, their end-of-trial appointment is on Friday. Thus, we recommend patients plan on staying in Dallas or Saddlebrook for 4 nights for the trial procedure. It is possible that you may require programming adjustments during the trial, which is done in-person with the device representative in Dallas or Saddlebrook.
Trip 2 (Permanent Procedure): Patients typically arrive in Dallas the day before their permanent procedure and depart Dallas the day of their post-op appointment. If a patient has a permanent procedure on Monday, their post-op appointment is on Thursday. Likewise, if a patient has their permanent procedure on Tuesday, their post-op appointment is on Friday. Thus, we recommend patients plan on staying in Dallas for 4 nights for the permanent procedure.
Post-Procedure Information and Care
After the procedure, it’s common to experience soreness, which can be managed with over the counter NSAIDS such as Aleve or Motrin, as well as ice packs that are initiated in the recovery room.
After the permanent procedure, as with any surgery, you can expect to be sore. Your physician will discuss with you the options for pain medication and a prescription will be sent to a pharmacy near the facility. If you live in the local area, your pharmacy can be used. Ice packs will be initiated in the recovery room. Most patients only take pain medication for a few days at most and then use an NSAID like Aleve.
Stage 1: Resuming Light Daily Activities:
Patients typically return to light daily activities within 2 to 3 days after the procedure. Some discomfort may be experienced but can usually be managed with prescribed medications. Light activities may include simple household chores, cooking, and other non-strenuous tasks.
Stage 2: Returning to Office Work or School:
Patients can resume office work or school within 1 to 2 weeks after the procedure. This timeframe allows for recovery from initial discomfort and ensures patients can comfortably engage in more sedentary activities.
Stage 3: Engaging in Strenuous Activities:
Strenuous activities, such as sports or vigorous exercise, should be avoided for approximately 6 weeks post-procedure. This extended recovery period is necessary for proper healing and minimizing the risk of complications or setbacks.
No, it’s unsafe to undergo an MRI if you have an implanted metal unit like a stimulator. However, this concern seldom causes significant issues, as there are alternative radiographic options available, such as CT and PET scans. If necessary, the stimulator can be temporarily removed to allow the patient to undergo an MRI, and then the device can be replaced afterward.
Patients are advised to avoid strenuous activities, such as contact sports, for approximately 6 weeks after the procedure to ensure proper healing. Otherwise, patients typically experience minimal physical limitations, if any, after the procedure. In fact, many find themselves feeling liberated from their chronic, severe head pain and are able to resume activities they couldn’t enjoy before
No, you shouldn’t encounter any issues with travel scanners at airports after the procedure. TSA screeners are well-trained in dealing with travelers with implants like pacemakers and implanted stimulators. They can easily scan or use a “hand wand” to check for these devices. Additionally, patients are provided with a card that identifies them as having an implanted neurostimulator, further facilitating smooth screening processes.
Technical Details and Device Information
The neurostimulator components are strategically positioned to maximize effectiveness and minimize risks. The battery is most commonly implanted subcutaneously in the left upper chest, where most people think of pacemakers being placed.
The implanted battery is rechargeable and designed to last between 8 to 10 years, providing a long-term solution for chronic head pain. As needed, the battery can be replaced through an elective outpatient procedure, ensuring continued relief for as long as the therapy is needed.
In most cases, the leads and battery are not noticeable under the skin, In fact, anyone considering the procedure can confirm this by viewing our many videos of actual patients.
The US Migraine Procedure differs significantly from external stimulators such as TENS units, Cefaly®, or Relivion®. Many patients who come to us have tried these devices without success, reporting minimal or no relief. While these external stimulators are worth trying, they typically attach to the forehead and operate on a preset program for a limited time, which may not cater to the individual’s specific needs.
In contrast, the US Migraine Procedure employs a neurostimulator that provides customized programming, tailored in real-time to the patient’s unique requirements. This device can be used continuously and allows for adjustments through an app on a phone, offering flexibility and control over the treatment. Our patients often experience dramatic, life-changing results with the US Migraine Procedure, even those who have had marginal or no success with external stimulators.
This personalized approach, with its ability to adapt to changing pain patterns, sets the US Migraine Procedure apart, offering a more effective and responsive solution for those suffering from chronic head pain.
Risks and Troubleshooting
The US Migraine Procedure carries risks common to all surgeries, including infection, although they are uncommon. Your physician will address these risks and answer any questions during your initial consultation.
If you encounter any issues with your device, we recommend reaching out directly to your device representative for support. In case you’ve misplaced their contact information, feel free to contact US Migraine for assistance. For any medical concerns related to the device, our team at US Migraine is here to provide guidance and support.
Long-Term Considerations and Device Management
After your initial post-op appointment, most patients won’t need to return to Dallas, TX for regular follow-up visits. We understand that treatments for head pain can become less effective over time, and our treatment is no exception. However, what sets our treatment apart is that it can be modified to return to its original level of effectiveness. If you notice a decrease in effectiveness, it’s crucial to reach out to your device representative promptly. They can easily reprogram the device remotely, ensuring optimal relief from chronic head pain.
The device used in the US Migraine Procedure is designed to provide long-term relief for chronic head pain, typically lasting about 8 to 10 years. When the device needs to be replaced at the end of this period, the process can be completed with an outpatient procedure.
Insurance and Financial Concerns
Yes! Our insurance specialists at US Migraine have over 30 years of expertise working seamlessly with a wide range of insurance carriers. Most commercial insurance carriers cover this procedure. Additionally, we proudly accept Medicare, making the treatment accessible to a wide range of patients. Our dedicated specialists are skilled at verifying benefits and obtaining prior authorization for the procedure, streamlining the process for our patients. Rest assured, you’ll receive confirmation of your insurance coverage well before any procedures, allowing you to approach your treatment journey with confidence and clarity regarding your financial responsibilities.
To determine if your insurance covers the US Migraine Procedure, we conduct a thorough verification process before we schedule your complimentary phone consultation with US Migraine Team. This involves collecting your insurance details and carefully reviewing your benefits to see if your plan includes coverage for this procedure.
Yes, self-pay options are indeed available for patients who do not have insurance coverage or whose insurance does not cover the US Migraine Procedure. We understand that every patient’s situation is unique, so we strive to make our treatments accessible. Additionally, we accept CareCredit, a healthcare credit card that can be used to cover out-of-pocket expenses not covered by insurance. To learn more about financing your procedure with CareCredit, please visit their website at carecredit.com.
Trial and Permanent Procedures
The trial procedure for the Us Migraine Procedure is a preliminary test to determine the effectiveness of a neurostimulator in alleviating chronic head pain. It involves temporarily placing a test stimulator under the skin, which is connected to an external battery pack. This trial helps predict whether the patient will experience relief from the permanent neurostimulator implant.
During the trial phase, patients are put under general anesthesia to ensure they are completely asleep and comfortable. While the patient is asleep, thin tubes are carefully inserted beneath the skin, like how IV tubes are placed. This is all done without making any surgical incisions, allowing for a non-surgical approach to the trial procedure.
After the patient awakens, the stimulator is activated, and they feel a tingling sensation in the areas treated, indicating the stimulator is working. The patient wears the temporary unit at home typically for 3 days, during which they are encouraged to engage in regular activities and even purposefully expose themselves to usual head pain triggers to test the stimulator’s effectiveness. After the trial period, the patient returns to the doctor’s office to provide feedback on the pain relief experienced, which will inform the decision to proceed with the permanent procedure.
The trial procedure for the US Migraine Procedure is essentially a short-term evaluation to determine if neurostimulation will alleviate your head pain. During this trial procedure, only the tips of the leads are inserted beneath the skin—no device is implanted. These leads are connected to an external battery that you can attach to your belt. For about 3 days, you’ll carry on with this setup, which allows you to assess whether the stimulator significantly reduces or eliminates your pain. If the trial significantly reduces your head pain, we can then proceed to discuss the option of a permanent implant. This next step involves surgically implanting the actual neurostimulator under the skin. Unlike the trial, all parts of the device are internal, and the battery is placed in the side of your chest. Now fully implanted, the leads target the nerves implicated in your head pain. This permanent solution is designed for the long haul, but it comes with the flexibility that the system can be removed if you ever decide to reverse it. And when the battery eventually depletes, it can be replaced through an elective outpatient procedure.
The trial procedure is a critical step before the permanent US Migraine Procedure to ensure its effectiveness for your specific case. It provides a real-life assessment of how the neurostimulator may alleviate your head pain without committing to the full procedure. A successful trial, which helps in pain relief for over 80% of patients, predicts a likely positive outcome for the permanent implant. If the trial does not significantly reduce your pain, it indicates that the permanent procedure would not be beneficial for you.
Typically, after the trial procedure, you’ll have a follow-up to discuss your experience and the effectiveness of the trial. If it’s successful and you opt for the permanent implant, US Migraine will seek prior authorization from your insurance company, which may take up to 30 business days. Once approved, the permanent procedure will be scheduled.
