Frequently Asked Questions
The battery produces a gentle electromagnetic field at the end of a long wire, linked to a small battery pack. It emits electrical pulses to the surface nerves in the forehead and back of the head. Almost instantly, headache pain gives way to a tingling or massaging sensation. Medical research indicates that as the device stimulates these surface nerves, it also activates deeper brain centers tied to headache triggers. This ensures a secure method of halting or even preventing headaches. Patients who respond well to the trial procedure and proceed with the permanent unit typically experience remarkable and swift results.
The Reed Procedure® is suggested for individuals with frequent, intense headaches that haven’t improved with other treatments. Typically, we look for two conditions to be fulfilled:
1. You experience 10 or more headache days each month.
2. You’ve attempted at least 6 months of medical management (headache medications) without success.
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.
Certainly, there is an extensive and ever-expanding body of research, with more than 100 papers published in peer-reviewed journals to date.
Dr. Reed’s groundbreaking contribution began with his 1999 publication on “Occipital Nerve Stimulation for Occipital Neuralgia.” Since then, a total of 111 clinical reports have been published, authored by 398 researchers from 144 research institutions (71 in the US, and 73 across Europe and beyond). To explore these papers and delve into the researchers and institutions involved, you can access the details via this link: Reed Procedure Research.
Moreover, within this community of authors and institutions, Reed Migraine has achieved significant milestones, as highlighted below:
Dr. Reed’s original report on “Occipital Nerve Stimulation” (an integral part of the Reed Procedure) was published in 1999, serving as the foundation for subsequent papers.
In 2009, Dr. Reed’s original publication on “Combined Occipital and Supraorbital Nerve Stimulation” (the Full Reed Procedure) marked another important milestone.
Collaborating with institutions like the Mayo Clinic SW and Duke Medical Center, Dr. Reed led a pivotal prospective multi-center study on “Occipital Neurostimulation,” solidifying Reed Migraine’s leadership role in the field.
Occipital Nerve Stimulation (ONS) uses an implanted device to stimulate nerves at the back of the head (occiput), while Supraorbital Nerve Stimulation (SONS) targets nerves over the forehead (supraorbital region). Together, they form the full Reed Procedure, known as “Combined Supraorbital and Occipital Nerve Stimulation.”
Choosing between ONS, SONS, or “Combined ON-SONS” depends on the pain’s location. ONS suits those with back-of-the-head pain, while patients with both front and back pain benefit from “Combined ON-SONS.”
Dr. Reed pioneered both procedures – ONS in 1992 and “Combined ON-SONS” in 2004. This expertise makes him and the RMC physicians he trained the most experienced globally in both ONS and the “Combined ON-SONS” (Full Reed Procedure).
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.
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.
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:
– Any type of shunt, such as “VP Shunt” or spinal fluid shunt
– History of repeated Lumbar Punctures (LPs)
– Pseudotumor Cerebri (Normal Pressure Hydrocephalus)
– Multiple Sclerosis
– Nerve Damage
– Previous nerve surgeries
– Any form of arthritis, including Rheumatoid Arthritis
– 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.
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.