I have chronic migraines and have had varying degrees of success with different treatments. Could occipital nerve stimulation help?

Answer From Jerry W. Swanson, M.D.

Occipital nerve stimulation is a surgical procedure that may be useful in the treatment of chronic and severe headache disorders, such as chronic migraines, that do not respond well to other therapies.

Occipital nerve stimulation was first used to treat headaches in 1977, but it's still considered a treatment in development.

The occipital nerve originates at the base of the neck. In occipital nerve stimulation, your doctor implants a small device at the base of the skull with leads connected to a power source (pulse generator) that sends electrical impulses to the occipital nerve.

The pulse generator is often implanted under the collarbone (clavicle), but the abdominal and buttock (gluteal) areas also are options.

Risks associated with occipital nerve stimulation include the possible need for surgical revision of wire placement after the procedure, as well as infection, pain and muscle spasms.

Research shows occipital nerve stimulation may improve headaches for some people, but the results are inconsistent.

In addition, studies on occipital nerve stimulation so far have included only a small number of participants, and long-term results are limited.

One study suggested about 40 percent of people with chronic migraine reported a sustained benefit up to four years after occipital nerve stimulation. Another suggested a similar benefit for people with chronic cluster headache up to six years after treatment. But both of these studies were without a blinded comparison group (uncontrolled), and a placebo effect may explain some of these benefits.

The bottom line? Although there's some evidence that occipital nerve stimulation may be effective in the treatment of chronic headache disorders, more studies are needed before the approach can be considered a routine headache treatment.

Aug. 02, 2019 See more Expert Answers

See also

  1. Acupuncture
  2. Aerobic exercise: What's the best frequency for workouts?
  3. Antidepressant withdrawal: Is there such a thing?
  4. Antidepressants and alcohol: What's the concern?
  5. Antidepressants and weight gain: What causes it?
  6. Antidepressants: Can they stop working?
  7. Antidepressants: Side effects
  8. Antidepressants: Selecting one that's right for you
  9. Antidepressants: Which cause the fewest sexual side effects?
  10. Atypical antidepressants
  11. Biofeedback
  12. Botox injections
  13. Caffeine and depression: Is there a link?
  14. Chiropractic adjustment
  15. Chronic daily headaches
  16. Clinical depression: What does that mean?
  17. CT scan
  18. CT scans: Are they safe?
  19. Depression and anxiety: Can I have both?
  20. Depression, anxiety and exercise
  21. Depression: Diagnosis is key
  22. Depression in women: Understanding the gender gap
  23. Depression (major depressive disorder)
  24. Depression: Provide support, encouragement
  25. Depression: Supporting a family member or friend
  26. Diarrhea
  27. Fish oil and depression
  28. Headache
  29. Headaches 101: Know your type
  30. Headaches and hormones
  31. Headaches in children
  32. Headaches: Treatment depends on your diagnosis and symptoms
  33. Depression and diet
  34. Lexapro side effects: Is breast tenderness common?
  35. Lumbar puncture (spinal tap)
  36. Male depression: Understanding the issues
  37. Managing Headaches
  38. MAOIs and diet: Is it necessary to restrict tyramine?
  39. Marijuana and depression
  40. Massage
  41. Massage therapy
  42. Mayo Clinic Minute: Prevent migraines with magnetic stimulation
  43. Mayo Clinic Minute Weathering migraines
  44. Migraine
  45. Migraine medications and antidepressants
  46. Migraine treatment: Can antidepressants help?
  47. Infographic: Migraine Treatments: Botox & Nerve Blocking
  48. Migraines and gastrointestinal problems: Is there a link?
  49. Migraines and Vertigo
  50. Migraines: Are they triggered by weather changes?
  51. Alleviating migraine pain
  52. Mild depression: Are antidepressants effective?
  53. Monoamine oxidase inhibitors (MAOIs)
  54. MRI
  55. Natural remedies for depression: Are they effective?
  56. Nausea and vomiting
  57. Nervous breakdown: What does it mean?
  58. Nighttime headaches: Relief
  59. Ocular migraine: When to seek help
  60. Pain and depression: Is there a link?
  61. Pain Management
  62. Prednisone risks, benefits
  63. Prednisone withdrawal: Why taper down slowly?
  64. Relaxation techniques
  65. Seeing Inside the Heart with MRI
  66. Selective serotonin reuptake inhibitors (SSRIs)
  67. Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  68. Sleep tips
  69. Stop your next migraine before it starts
  70. Stress and headaches: Stop the cycle
  71. Symptom Checker
  72. Treatment-resistant depression
  73. Tricyclic antidepressants and tetracyclic antidepressants
  74. Migraine aura
  75. MRI
  76. Vitamin B-12 and depression
  77. What's causing my infant's diarrhea?