If you are one of the millions who suffer from migraines, you know that they can range from mild annoyance to complete debilitation. When a migraine attacks, all you want is relief.
Traditional treatments like pain medication can help, but side effects (or just being ineffective) can deter many. This is where TENS therapy comes in.
TENS, or Transcutaneous Electrical Nerve Stimulation, is a drug-free treatment option for pain relief that uses low-voltage electrical current to stimulate the nerves. Let’s explore the best TENS placements you can try for migraine headache relief.
Where should I place the TENS Pads?
1. The back of the neck
This provides neck muscle and sub-occipital nerve stimulation (the nerves under the base of the skull). If neck treatment tends to relieve your headache, this is a good placement for the tens pads.
Not a migraine, but you have left-sided neck pain? Read up on neck and shoulder pain causes.
2. Across the forehead
This placement targets the nerve we know has connection with migraine: The trigeminal nerve. Use this placement to stimulate the supraorbital nerve branches of the trigeminal. Use as a combo with 4 below.
3. Over the temples
To target the temporalis muscle, and trigeminal nerve branches that travel to the Dura. The dura partly makes up the physical barrier of tissue covering your brain, and has nerves that travel to it.
4. On either side of the lower nose
This placement is for external trigeminal nerve stimulation of some lower branches in your face. Aim just under the pointy part of your cheek bones.
5. Over the jaw (TMJ)
Try a tens placement here, with pads also over the mastoid (bone behind your ear), with further neck or face placements. Explore our post on the links between TMJ and migraine to learn more.
6. On either side of the head, just behind the ears (mastoid). See above.
Try a combination of the above locations. For example, pads over the TMJ, mastoid, neck, and trapezius muscle – a good arrangement for right-sided ear and neck pain.
The above are key spots for nerve stimulation to your brain. For example, the jaw joint (TMJ) has strong input, and jaw pain often accompanies headaches and migraine. Stress is a common factor to understand here.
The great thing about TENS is you can quickly feel which pad arrangement gives you the best relief.
How does TENS work for migraine?
A battery-powered device, TENS units produce electrical currents interfere with pain signals being sent to the brain. This interruption provides pain relief by effectively “blocking” the pain signals from a migraine attack.
As additional bonuses, the stimulation of the nerves by the electrical current also triggers endorphins, which are natural painkillers produced by the body.
Gate control theory
The gate control theory of pain suggests that there are two types of nerve fibers in our skin, fast and slow. The fast fibers are responsible for transmitting pain signals quickly, while the slow fibers transmit information about touch, pressure and vibration.
TENS works by stimulating the slow fibers, which overrides the pain signals from the fast fibers. This is why TENS can provide relief from chronic pain, as it interrupts the transmission of those pain signals to the brain.
If you suffer from migraines, TENS might be a treatment option worth considering. Drug-free and relatively inexpensive, TENS has been shown to provide significant relief for many people who suffer from migraines.
Why does TENS placement matter?
The placement of the TENS pads on the body dictates what nerves are stimulated. For example, placing the pads on the front of the head, and the face, will primarily stimulate the trigeminal nerve, which has been shown to play a role in migraine.
At the back of the head are the occipital nerves, and in the neck are spinal (cervical) nerve root branches.
Try first to follow the recommended placements, but of course you can experiment with different positions to find where you feel the most relief.
When using a TENS unit for migraine headaches, it’s also important to adjust the intensity and frequency settings until you find that sweet spot. If you can get relief on a low setting (with or without a tingling sensation), there’s no need to turn it up for the sake of it.
TENS pad placement for Sciatica
TENS and Migraine FAQ
TENS should not be used by:
– pregnant women
– people with pacemakers or other implanted electrical devices
– anyone with a seizure disorder
What are some electrical TENS alternatives for migraine?
The last few years has seen an explosion of new neuromodulation devices that make an electric current. People are increasingly using these smarter, newer devices for episodic migraines, cluster headaches, tension headaches and more.
So, you can skip the trip to the physical therapist if you find relief for your type of headache! Here is a list of some modern pain management alternatives to tens devices, which you may want to learn more about.
- Cefaly is a FDA-approved prescription device specifically for migraine prevention and relief. Like TENS, it uses electrical stimulation to treat migraine headache pain.
- According to Cefaly, it works by stimulating the trigeminal nerve, and boasts acute and preventative settings. The placement of the Cefaly is directly on the front of the forehead, secured with sticky pads. The latest model is called Cefaly Dual.
- The Relivion device by Neurolief has been shown in this study to be effective for migraine pain, compared to a sham treatment.
- The method of action is called eCOT-NS, which simply means the electrical currents target the occipital and trigeminal nerve branches in your head and face.
Others of note
- The Gammacore Saphire is different in that it stimulates the Vagus nerve – a different cranial nerve branch that runs from your brainstem down to your abdomen. It is reported to work around 50% of the time, and has a long-lasting effect (up to 48 hrs).
- Nerivio is a device that is attached to the upper arm, and creates local stimulation at peripheral nerves there. It is for those over 12 years of age, and comes with an app to control it, including a diary function for migraine tracking.
- The Savi Dual uses yet another avenue: transcranial magnetic stimulation (sTMS). This approach more broadly targets the brain itself, to reduce migraine pain.
It is important to avoid placing the electrode pads directly on top of the spine or on any area with broken skin, or near your eyes. If you have any questions about where to place the sticky pads, be sure to consult your doctor or other medical professional before using TENS.
Remember to follow manufacturer instructions for proper TENS usage.
Which TENS pad arrangements have you found give you relief? Let us know below.
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