Feared by many, migraines can be classed as a form of torture for those unfortunate enough to suffer with them. Those lucky enough to escape the torment of a migraine, can be forgiven for thinking they are a just headache. However, migraines aren’t just a ‘headache’ which comes and goes as it pleases. Instead they can be debilitating, stopping the sufferer from working and carrying out their daily lives. While for those who do not suffer with them it is hard to imagine what ‘all the fuss’ is about.
For myself migraines are not such an issue. I appear to suffer with headaches which, according to my GP, is nothing to worry about. This is fine until I rely on my friend’s paracetamol and ibuprofen to attack the pain in my head and send it on its way. However, there are members of my own family who are unfortunate enough to suffer with migraines and chronic pain. My mum is a prime example. She suffers with occipital neuralgia, a nasty chronic pain condition which is not only debilitating for her at times but horrendous for us to witness too.
According to the Migraine Trust, migraine is the third most common disease in the entire world, with 1 in 7 people affected globally. However, those suffering from chronic migraine make up 2% of the world’s population. In the UK, migraines cost the NHS around £150 million per year in prescription drugs and treatment. However, the burden to the working economy is staggering. Days off from work costs around £2.25 billion per year. So, migraines are not only a burden to those who suffer with them but they have a negative impact on the UK economy too. Despite all of this, migraine is the least publicly funded of all neurological illnesses including dementia and psychosis.
What is a migraine?
A migraine is a common condition in the UK, affecting 1 in 5 women and 1 in 10 men. It is often a severe throbbing headache on one side of the head. However, this is not always the case as there are a number of different types of migraine. These can include:
- Migraine with aura
- Before the migraine begins you get warning sign such as flashing lights
- Migraine without aura
- The migraine just comes on with no warning signs
- Migraine aura without headache
- Aka silent migraine
- When the warning signs for a migraine are there or other symptoms but a headache doesn’t develop
- Chronic migraine
- Such as cluster headaches, occipital or trigeminal neuralgia
In short, a migraine is a neurological condition which can affect the whole body and not just the head. Other symptoms can include nausea, vomiting, sensitivity to light, paralysis, speech difficulties, abdominal pain and deafness. Not everybody presents with the same symptoms so an attack can last anywhere between 4 and 72 hours, sometimes longer.
The cause of a migraine is not exactly known. However, changes in brain activity which affect nerve signals, chemicals and blood vessels in the brain are thought to be responsible. Genetics may also play a role. Your genes may leave you more susceptible to getting migraines as you may react to a specific trigger. These triggers can be anything from hormonal, physical, emotional, dietary, environmental or medical changes.
What about chronic pain migraines?
For this, I’m going to focus on occipital neuralgia as it is a condition I have seen first-hand. It all started about 10 years ago when my mum first mentioned she couldn’t bear to touch a certain spot on the back of her head. She said it was fine most of the time except when she needed to touch it i.e. washing or brushing her hair. None of us thought anything of it until the pain suddenly became constant about 4 years ago. One night I could hear crying from the kitchen and to my horror I found my mum doubled up in pain, clutching her head. We took a trip to A & E, was told it was probably stress and came home with a box of Codeine. The problem was the pain didn’t go away. All in all it took about a year for a diagnosis of occipital neuralgia to be made. Mum was prescribed medication after medication, but nothing touched the pain. She had an MRI scan to rule out anything nasty and endured nerve block injections at the point of pain but nothing worked. She was even offered Botox, 33 injections all over her head and no guarantee it would actually work. No thank you. Then about 18 months ago she was offered to try a brand-new device, gammaCore.
Before I go any further I should explain what occipital neuralgia is.
It is characterised by a sharp, stabbing pain at the back of the head and upper neck. With severe occipital neuralgia patients can have severe headaches which are unable to be controlled by methods such as nerve blocks or antidepressants. Typically, the pain appears on one side of the head but there is the possibility of both sides being painful if both occipital nerves are affected. The bouts of pain associated with occipital neuralgia can last anything from a few seconds to being continuous.
The condition is caused by damage to the occipital nerves. This can arise from trauma (usually involving concussion), physical stress on the occipital nerve, flexion, extension or contraction of the neck on a regular basis or it can be due to medical complications. At times, the symptoms of occipital neuralgia may also be similar to those experienced by migraine sufferers.
The thing is, this is a condition I had never heard of before mum was diagnosed with it. Although, it doesn’t seem very common either, on visits to hospital appointments with her, I met many people suffering with the same problems. Some who had even given up work because the pain was so intense they couldn’t concentrate on anything else. Others who had to wear sunglasses all day and into the night because their eyes were so sensitive to the light.
So what next?
Well, mum tried everything which was offered to her except the Botox. Medication that made her fall asleep and at times go doolally, nerve block injections which in the end made the pain worse, as well as over the counter meds but still nothing touched the pain. Until her neurologist suggested a new device called gammaCore, not guaranteed to work and not directly funded by the NHS at the time either. But it was worth a go, right?
After a trial period it seemed this was the answer every occipital neuralgia patient had been waiting for. Finally, a device which could successfully take the pain away.
How does it work?
GammaCore provides non-invasive vagus nerve stimulation. Users place the device on their neck over the cervical branch of the vagus nerve, until they feel small muscular contractions. The vagus nerve sends messages from the brain and into the body and vice-versa, activating chemicals called neurotransmitters along the way. These have important roles in our body’s function. Excitatory neurotransmitters excite our nervous system whereas inhibitory neurotransmitters calm the nervous system down. When we get a headache we have too may excitatory neurotransmitters at work and not enough inhibitory ones to calm it down. The gammaCore provides a balance by supplying an electrical signal to the vagus nerve as it travels back to the brain via the neck. By balancing the excitatory and inhibitory neurotransmitters, gammaCore safely and efficiently blocks the pain associated with occipital neuralgia.
Although there are a number of other digital devices and apps available for people who suffer with headaches, migraines and chronic conditions, gammaCore is one where I have fully appreciated the results. The future looks promising with regards to treating conditions such as occipital neuralgia and migraines with digital technology. With statistics showing that around half of migraine patients using gammaCore had experienced pain relief and 20% claimed their pain had gone completely, technology is offering a novel alternative to pharmacological interventions.
ScienceLED 
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