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.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Aug. 02, 2019 See more Expert Answers

See also

  1. Acupuncture
  2. Antidepressant withdrawal: Is there such a thing?
  3. Antidepressants and alcohol: What's the concern?
  4. Antidepressants and weight gain: What causes it?
  5. Antidepressants: Can they stop working?
  6. Antidepressants: Side effects
  7. Antidepressants: Selecting one that's right for you
  8. Antidepressants: Which cause the fewest sexual side effects?
  9. Antiphospholipid syndrome
  10. Atypical antidepressants
  11. Biofeedback
  12. Botox injections
  13. Chiropractic adjustment
  14. Chronic daily headaches
  15. Clinical depression: What does that mean?
  16. CT scan
  17. Depression and anxiety: Can I have both?
  18. Depression, anxiety and exercise
  19. What is depression? A Mayo Clinic expert explains.
  20. Depression in women: Understanding the gender gap
  21. Depression (major depressive disorder)
  22. Depression: Supporting a family member or friend
  23. Diarrhea
  24. Headache
  25. Headaches and hormones
  26. Headaches in children
  27. Headaches: Treatment depends on your diagnosis and symptoms
  28. Lumbar puncture (spinal tap)
  29. Male depression: Understanding the issues
  30. Managing Headaches
  31. MAOIs and diet: Is it necessary to restrict tyramine?
  32. Marijuana and depression
  33. Massage therapy
  34. Mayo Clinic Minute: Prevent migraines with magnetic stimulation
  35. Mayo Clinic Minute: Weathering migraines
  36. Migraine
  37. What is a migraine? A Mayo Clinic expert explains
  38. Migraine medicines and antidepressants
  39. Migraine FAQs
  40. Migraine treatment: Can antidepressants help?
  41. Migraines and gastrointestinal problems: Is there a link?
  42. Migraines and Vertigo
  43. Migraines: Are they triggered by weather changes?
  44. Alleviating migraine pain
  45. Monoamine oxidase inhibitors (MAOIs)
  46. MRI
  47. Natural remedies for depression: Are they effective?
  48. Nausea and vomiting
  49. Nervous breakdown: What does it mean?
  50. Nighttime headaches: Relief
  51. Ocular migraine: When to seek help
  52. Pain and depression: Is there a link?
  53. Pain Management
  54. Prednisone risks, benefits
  55. Prednisone withdrawal: Why taper down slowly?
  56. Relaxation techniques
  57. Seeing inside the heart with MRI
  58. Selective serotonin reuptake inhibitors (SSRIs)
  59. Serotonin and norepinephrine reuptake inhibitors (SNRIs)
  60. Sleep tips
  61. Symptom Checker
  62. Treatment-resistant depression
  63. Tricyclic antidepressants
  64. Migraine aura
  65. MRI
  66. Vitamin B-12 and depression