Frequently Asked Questions
In the Reed Procedure®, an implantable neurostimulator is placed underneath the skin at the target areas to control migraine headaches. Similar to a pacemaker’s purpose for the heart, where a small battery is placed under the skin and a tiny wire passes up to the heart to pace it, the same is true for the implantable neurostimulator. For headache sufferers, tiny wires pass underneath the skin to superficial locations in the head, and once turned on, effectively stop the headache. The success rate is over 80%. The battery lasts up to 10 years and when in need of replacement, consists of a quick 30-minute procedure. The implantable neurostimulator is completely reversible and can be removed at any time.
The battery generates a mild, electromagnetic field at the tip of a long wire, connected to the small battery pack, and emits electrical pulses to the superficial nerves in the forehead and back of the head. Headache pain is then replaced with a tingling or massaging sensation almost instantly. Medical studies show that while the device is stimulating the superficial nerves, it is also stimulating deep centers in the brain related to the areas important in the modulation and genesis of headaches. Thus, the neurostimulator works in a very safe fashion to stop or prevent headaches from occurring altogether. For patients who positively respond to the trial procedure and move forward with the permanent unit, the response is dramatic and results are often immediate.
The Reed Procedure is recommended for patients who have frequent, severe headaches that have not responded to other treatments. We generally ask that two criteria be met:
- You have 10 or more headache days per month, and
- You have tried at least 6 months of medical management (headache medications) and nothing is working.
The implantable neurostimulator devices that we use today are manufactured by St. Jude Medical, Boston Scientific, and Medtronic Corp and have been fully FDA approved devices for over 40 years for chronic back and neck pain.
And, after over 2 decades of use, the neurostimulator implant procedures that we use are accepted as a standard of care across the medical community, as an “off label” application for chronic head pain.
Further, Medicare and most commercial and national carriers now approve implantable peripheral neurostimulation for various types of chronic head pain and/or headaches. For example, Medicare’s national policy indeed now fully approves implantable neurostimulation for treatment-resistant chronic migraines.
Yes, there is a large and growing body of research with over 100 papers published to date in peer-reviewed journals.
In fact, Dr. Reed published the original paper on the subject in his 1999 publication of “Occipital Nerve Stimulation for Occipital Neuralgia.” That paper started things out, and since Dr. Reed’s original paper, there have been a total of 111 published clinical reports on research conducted by 398 researchers representing 144 research institutions (71 in the US, and 73 from across Europe and elsewhere). You may download the details of the papers and review the researchers and institutions by clicking this link: Reed Procedure Research.
Further, of these authors and institutions, Reed Migraine has taken a leadership position, noting the following landmarks:
Reed published the original paper on “Occipital Nerve Stimulation” (a component of the Reed Procedure) in 1999. All of the other papers follow his original report.
Reed published the original paper on “Combined Occipital and Supraorbital Nerve Stimulation” (the Full Reed Procedure) in 2009.
Reed partnered with several in institutions including the Mayo Clinic SW and Duke Medical Center in the foundational prospective multi-center study on “Occipital Neurostimulation and Chronic Migraine” underwritten by St. Jude Medical and published in 2014.
Occipital Nerve Stimulation (ONS), which is an implanted unit that stimulates the nerves over the back of the head (occiput), is actually a component of the full Reed Procedure. The other component of the full procedure is Supraorbital Nerve Stimulation (SONS), which results in stimulation of the nerves over the forehead (supraorbital region). Therefore, the medical term for a full Reed Procedure is “Combined Supraorbital and Occipital Nerve Stimulation.”
In actual practice, the decision of what modality to use in an individual patient — ONS, SONS, or “Combined ON-SONS” — is based on where the patient feels the pain. If the pain is confined to solely the back of the head, then ONS alone should suffice. However, for patients that experience pain over both the back and front of the head, the “Combined ON-SONS” procedure (full Reed Procedure) is recommended.
Dr. Reed was actually the first physician in the world to do both procedures – ONS in 1992 and “Combined ON-SONS” in 2004. As such, he and the other RMC physicians that he personally trained are the world’s most experienced in both ONS and “Combined ON-SONS” (Full Reed Procedure).
Neurologist Referrals: Many neurologists do refer patients to us. Some of the most respected names in the field, in fact, are strong proponents of the Reed Procedure. Dr. Reed has even collaborated on research related to this procedure with renowned institutions like the Mayo Clinic, Duke Medical Center, and Thomas Jefferson Medical Center.
Published Research: The efficacy and benefits of the Reed Procedure are well-documented. There are over 120 independent research publications that have delved into this topic. For those interested in diving deep, all these papers are available for download on our website.
The Trial Stimulator – See for Yourself: Above all, our approach empowers patients. We’re not asking anyone to just “believe” in the procedure based on our say-so or even the research. With the trial stimulator, patients can personally experience and assess the effectiveness of the treatment. This hands-on trial allows each patient to make an informed decision based on their own experience.
US Migraine FAQ's
At US Migraine, we’ve got some of the most experienced doctors who specialize in using implantable neurostimulation to treat migraines. Dr. Reed and his team actually came up with the Reed Procedure, which is now used all over the world. So, we’ve been at this for over 25 years – longer than anyone else. And Dr. Reed doesn’t just rest on his laurels; he keeps publishing new research, giving talks, and teaching other doctors from around the globe.
Dr. Reed’s groundbreaking research paper that introduced the Reed Procedure® to the field of headache specialists earned him the esteemed Cephalalgia Award. This award, given by the editors of the medical journal Cephalalgia, presented by the International Headache Society, is bestowed every two years to the best paper published in the journal during that time. Dr. Reed and Dr. Will not only received the award certificate but were also invited to present their paper at the annual congress of the International Headache Society in September 2009.
The International Headache Society consists of leading neurology headache specialists from around the globe. The journal receives numerous original articles annually from top academic institutions like Stanford, Cambridge, and Johns Hopkins.
This recognition, along with the publication of The Reed Procedure® paper, underscores the procedure’s potential for revolutionizing future head pain treatment.
Absolutely! Many of our patients have shared that having the neurostimulator implanted has given them their life back. They’re venturing outdoors, reconnecting with loved ones, and experiencing pure joy. While the primary goal is headache treatment, there are also numerous additional advantages. As pain management experts, it’s incredibly rewarding to witness our patients embrace a fresh perspective on life, engaging in everyday activities they once believed were beyond reach prior to undergoing The Reed Procedure®.
Yes! A Patient Ambassador is someone who has experienced The Reed Procedure® and can provide valuable insights to other individuals contemplating both the trial and permanent implant. Our Patient Ambassador initiative features 20 former patients who have graciously dedicated their time to address questions from those considering the procedure, offering firsthand accounts of their journeys. To discover more about these Patient Ambassadors and access their contact information, simply explore our Patient Ambassador Program. We enthusiastically encourage potential candidates for The Reed Procedure® to explore this opportunity and gain direct perspectives from our past patients on how the procedure transformed their lives.
Insurance FAQ's
Definitely! You can find more details on our insurance page by clicking here!
Our Insurance Specialists at US Migraine have a wealth of experience spanning over 25 years in effectively collaborating with various insurance carriers. They’re adept at confirming benefits and securing precertification for the procedure. Transparency is a cornerstone for us, and our specialists will ensure you’re well-informed at every step. The important thing to note is that you’ll receive confirmation of your insurance coverage before any procedures take place.
Clinical FAQ's
Absolutely, we’ve achieved positive outcomes with numerous patients who’ve undergone a range of surgical approaches to address their migraines. These methods can involve nerve ablation or other nerve-focused surgeries. If you find yourself still dealing with considerable head pain even after such procedures, we suggest arranging a free phone consultation with Dr. Reed. This way, he can delve into your unique case and provide more personalized insights. Booking a phone consultation is easy – simply click on this link: Phone Consultation Request.
The Reed Procedure® has shown success in treating almost all kinds of long-lasting 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
– New Persistent Daily Headache
– 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
Absolutely. We’ve successfully treated numerous patients dealing with Hemiplegic Migraine, and the outcomes have been remarkable. These patients not only experienced relief from their migraines but also found alleviation from the associated hemiplegic weakness or numbness. One of our former patients, Kelsey, even recorded an amazing video showcasing the impact of the stimulator on her hemiplegic migraine. You can see the transformative effect of the Reed Migraine Procedure in action by watching Kelsey’s video by clicking here!
Yes, in addition to relieving the migraine pain, the Reed Procedure® typically also relieves associated symptoms, including auras.
Neurostimulation is a well-established and widely accepted treatment with a long history. The procedure involves a relatively small battery implanted under the skin, carrying minimal risks or disadvantages. The Reed Procedure® is a two-step approach, starting with a trial. The trial’s benefits are evident: if successful, patients experience positive outcomes. The trial and permanent procedure have no physical downsides or limitations. They don’t exacerbate headaches or harm nerves. However, the downside is for the roughly twenty percent for whom the trial doesn’t work, leading to disappointment. Concerning the permanent procedure, there is a slight risk of infection, as seen in many surgeries, but it’s manageable.
No, it’s not possible 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. In our extensive experience of performing numerous implants over the last 25 years, there’s been just one case where an MRI was necessary. In that situation, we temporarily removed the stimulator to facilitate the MRI, promptly re-implanting it afterwards.
Trial Stimulator FAQ's
The trial stimulation offers patients a direct experience of the sensation of a permanent stimulator. Throughout the trial period lasting three to seven days, patients can easily assess any change in the severity of their headaches. This conclusive trial has demonstrated a success rate exceeding 80%. Therefore, if the trial is effective, the permanent procedure is expected to yield consistent results. During the trial period, we encourage patients to maintain their regular activities, as the wires can be concealed under clothing. The trial pack can also be attached to the beltline for convenience. We recommend patients intentionally try to trigger a headache while in the trial period to accurately gauge the stimulator’s effectiveness. For instance, if sunlight usually triggers headaches, we suggest patients test the stimulator’s efficacy by exposing themselves to sunlight.
We use a test stimulator to check if it can help with headaches. We put a temporary unit under the skin for a few days. If it works, the relief is quick and big. After a few days, the patient comes back to tell us how it went. This test happens at the hospital and takes about 15 minutes. The patient gets sleepy medicine through a tube, and then tiny tubes are put on the forehead and back of the head. No cuts are made during this. When the patient wakes up, there are small wires coming out from the forehead, connecting to a battery box outside the body. A person from US Migraine makes the system work in the recovery room. The patient feels a tingly feeling in the forehead and back of the head. The patient wears the temporary unit for a few days at home. Usually, the effects are strong, and the patient knows if it’s helping very soon. After the test time, the temporary unit is taken out. If headaches don’t feel much better, the patient might not be a good fit for The Reed Procedure®. But if the test stimulator works well, the patient can get the permanent one in a couple of weeks.
Lifestyle FAQ's
The recovery after the Reed Procedure® can be divided into three stages, each with different timeframes for getting back to different activities:
1. Resuming daily activities and travel: Most patients can get back to regular activities like driving, shopping, and traveling within 2-3 days after the procedure. Some discomfort might be there, but it can be managed with medicine so that patients can do these activities comfortably. Some patients even travel home within just three days after the surgery.
2. Returning to school or work (for office jobs): Generally, patients can go back to school or work around 5-7 days after the procedure. For example, if the permanent stimulator is implanted on a Tuesday, the patient could return to school or work by the following Monday.
3. Engaging in strenuous activities: Activities like contact sports, skiing, or gymnastics need about 6 weeks of recovery time. This helps ensure proper healing and avoids complications or setbacks in the recovery process.
Cosmetic changes are rare. Usually, friends and family can’t tell if a patient has an implanted unit. Our patients often experience minimal physical limitations, if any. In fact, the opposite is true. Having the unit implanted and being free from chronic headaches makes our patients feel liberated. They can do things they couldn’t before, like going outside, enjoying physical activities, and even eating trigger foods that were problematic before the permanent procedure.
No, there are no problems at all. TSA screeners are well-trained in dealing with travelers who have implants like pacemakers or implanted stimulators. They can easily scan or use a “hand wand” to check for these devices. Patients also carry a card that identifies them as having an implanted neurostimulator, but even without the card, there’s no issue with TSA screening.
Since we treat patients from all across North America, many of our patients come from out of town. Our process to help you manage your headaches involves two separate trips:
**Trip 1:** This trip is for the Trial Stimulator placement, and it requires a 2-night hotel stay. You can have the trial procedure at any of our locations. After the initial 2 days, you can return to your hometown and have the trial stimulator removed by a nurse or physician there.
**Trip 2:** This trip is for the Permanent Stimulator placement and involves a 3-night stay in a Plano, TX hotel. The permanent procedure is performed only in Plano, TX. Once the permanent unit is in place and healed, there’s usually no need for additional trips to Dallas. Your local physician can handle any follow-up needs. While we’re available 24/7 for questions or issues, under normal circumstances, there’s no need to return for appointments.