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Transcranial Magnetic Stimulation (TMS) for Chronic Migraine

Medically Reviewed by Christopher Melinosky, MD on February 14, 2022

You’re probably most familiar with taking medicines for your chronic migraines. Pain relievers can help you get rid of symptoms as they happen. Other migraine medicines taken regularly can help you prevent the next migraine. You also can try and help your migraines by avoiding the things that trigger them for you.

But there’s a newer way you can try to treat or prevent your migraines: by using a special device instead of or along with your medicines. It’s called TMS, short for transcranial magnetic stimulation. TMS delivers painless magnetic pulses to your scalp. It’s not clear exactly how it works, but the idea is that those pulses can change how your brain is working to help you in various ways.

Evidence for Transcranial Magnetic Stimulation (TMS) in Chronic Migraine

Doctors have used TMS to treat other conditions that affect the brain. These include depression, seizures, and obsessive-compulsive disorder (OCD). But TMS may help with lots of other conditions, including migraine. Researchers are still learning more about all the ways it can help and how it works.

A recent review looked at eight studies testing TMS for treating migraine. Altogether the studies included a little more than 200 people who finished treatment. Two of them showed good evidence that TMS placed against your skin over a part of your brain called the motor cortex helps with migraine. The treatment made migraines happen less often. TMS also made migraines less severe.

For example, one study from 2010 tested whether a portable TMS device was safe and helped people with migraine including those with aura. Auras usually are visual warnings or other signs that happen before a migraine. The study put about 100 people in a group that got magnetic stimulation to treat their migraines while they had an aura. Another 100 people got a fake device to use when they had signs that a migraine was coming.

People in the study who used the real TMS device more often said they weren’t in pain 2 hours later compared to people who used the fake device. They also more often stayed pain-free over the next day or two.

Another study in 2018 looked at whether a TMS device could prevent migraines from happening. In the study, people who got the treatment gave themselves four magnetic pulses twice a day. They also got three pulses up to three times when a migraine was coming on. People in the study kept track of their headaches and use of their medicines or the TMS device.

At the beginning of the study, people had about 9 headache days a month. Afterward, those who used TMS reported having headaches less often. The number of headache days was reduced by about 3 days on average. They also used medicines to treat their migraines less often.

TMS doesn’t work for everyone. The evidence is also somewhat limited. But what’s available suggests it may be a safe and effective option to treat or prevent your chronic migraines. It might be worth considering if your doctor thinks it’s OK, especially if you don’t tolerate or respond well to migraine medicines. Some people also might prefer using magnetic stimulation instead of taking medicine.

How Transcranial Magnetic Stimulation (TMS) Works

Inside a TMS device, you will find one or two copper coils. The device can be placed against your head over different parts of your brain. It will deliver brief magnetic pulses to your scalp. The magnetic pulses form a mild electric current in the outer surface of your brain.

Your doctor will tell you how many pulses you need or how often to use TMS. It’s not clear exactly how it works, but the idea is that it changes brain activity that’s causing your migraine symptoms. The magnetic pulses also might change the way you process or feel pain.

You can get TMS in a portable device your doctor would prescribe. It also may be possible to have TMS treatments in a doctor’s office.

Transcranial Magnetic Stimulation (TMS) Side Effects and Risks

Most people who try TMS don’t have trouble with it or notice any side effects. Possible side effects of TMS may include:

  • Feeling lightheaded or dizzy
  • Tingling
  • Tinnitus (ringing in your ears)
  • Feeling irritable or tired
  • Seizure
  • Headache

The side effects that people have reported so far are usually minor and go away. Since TMS hasn’t been used for very long, it’s not clear how well it works in the long term or if there could be any long-term effects. It’s less clear also if it works for people who have migraine without aura.

TMS isn’t a good idea if you have seizures. You may also not be able to use it if you have metal or an implanted device in your body.

Why Choose Transcranial Magnetic Stimulation (TMS) for Migraine?

TMS is most likely to help if you have chronic migraines and other medicines aren’t working for you. There are many reasons why you may want to consider it. These may include:

  • If you use a lot of medicines for other conditions and are worried about interactions.
  • If you can’t take pain relievers or other medicines used to treat migraine.
  • If you want to take pain relievers less to help avoid medication overuse or rebound headaches.
  • If you want to avoid medicines for other reasons.

Ask Your Doctor

If you have chronic migraines and are interested in trying TMS, ask your doctor if it's an option in your case. You should let your doctor know if you have:

  • Any metal or other implanted devices
  • Other medical conditions
  • A mental health condition
  • A history of seizures

Show Sources

SOURCES:

Migraine Canada: “Magnets for migraine: magnetic stimulation.”

The Migraine Trust: “Medical Devices.”

Mayo Clinic: “Transcranial Magnetic Stimulation,” “Migraine Aura.”

Neurology of Systemic Diseases: “Transcranial Magnetic Stimulation as Treatment in Multiple Neurologic Conditions.”

Cephalalgia Reports: “A systematic review of high-frequency transcranial magnetic stimulation on motor cortex areas as a migraine preventive treatment.”

The Lancet Neurology: “Single-pulse transcranial magnetic stimulation for acute treatment of migraine with aura: a randomised, double-blind, parallel-group, sham-controlled trial.”

Medscape: “TMS Device May Offer Nondrug Option for Migraine Prevention.”

Clinical TMS Society: “Transcranial Magnetic Stimulation (TMS) Use to Treat Migraine - A Local Case Series Study.”

Johns Hopkins Medicine: “Brain Stimulation: TMS.”

NHS UK: “Migraine.”

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