Introduction

Migraines are debilitating neurological conditions characterized by severe headaches, often accompanied by symptoms such as nausea, vomiting, and sensitivity to light and sound.¹ These episodic attacks can significantly impact individuals' quality of life, leading to missed workdays, decreased productivity, and diminished overall well-being. Despite advancements in migraine management, many sufferers continue to seek alternative or complementary therapies to alleviate their symptoms effectively.

One such alternative approach that has gained attention in recent years is magnetic therapy. Rooted in the principles of electromagnetic fields and their potential effects on the body, magnetic therapy involves the use of magnets or magnetic fields to alleviate pain and promote healing.² While magnetic therapy has been explored in various medical contexts, its application in migraine treatment has sparked particular interest due to its non-invasive nature and potential for minimal side effects.²

This article aims to provide a comprehensive overview of magnetic therapy for migraines. It will explore the aetiology and pathophysiology of migraines and how they can be alleviated through the underlying mechanisms of magnetic therapy, whilst also considering research evidence, application methods, safety considerations, and patient perspectives.

By delving into the current state of knowledge surrounding magnetic therapy for migraines, we aim to equip readers with valuable insights into this alternative treatment approach and its potential role in the management of migraines. Ultimately striving towards improved outcomes and enhanced quality of life for individuals affected by migraines.

Understanding migraines

Migraine definition and pathophysiology 

Migraine is a subtype of headache, characterised by recurrent attacks of moderate to severe throbbing and pulsating pain. Typically, it occurs unilaterally (on one side of the head), however it can be present on both sides of the head.¹ The underlying pathophysiology of migraines is underpinned by the hyperexcitability of nerve fibres within the walls of the blood vessels that travel in the meninges (layers of membrane) of the brain.³

Prevalence

Migraine is a highly prevalent condition, affecting 12% of the world’s population and is denoted as the second leading cause of disability worldwide.⁴ It affects women more than men (17% and 6% yearly, respectively).⁴ Geographically, its prevalence is highest in North America, followed by South America, Central America, Europe, Asia and Africa.⁴

Aetiology

Migraine has a strong genetic component, with familial history posing an increased risk of 3x.⁴

Subtypes

Migraines are classified into 6 subcategories:⁴

Migraine without aura

This is a recurrent headache attack lasting 4 to 72 hours with typical migraine symptoms that do not include aura.

Migraine with aura

Migraine symptoms associated with aura; a fully reversibly attack, lasting minutes with additional symptoms of visual, speech and language, motor, brainstem or retinal dysfunction.

Chronic migraine 

A headache that occurs on 15 or more days in a month for more than three months.

Migraine complications 

• Status migrainous - a debilitating migraine that occurs on 15 or more days in a month for more than three months 
• Persistent aura without infarction - an aura persisting for more than one week without evidence of infarction on neuroimaging 
• Infarction- one or more aura symptoms associated with brain ischaemia during a typical migraine attack
• Migraine aura-triggered seizure - a seizure that is triggered during a migraine with an aura attack 

Probable migraine

A symptomatic migraine attack that lacks one of the features required to fulfil the criteria for one of the above and does not meet the criteria for another type of headache.

Episodic symptoms that may be associated with migraine 

• Recurrent gastrointestinal disturbances are recurrent attacks of abdominal pain and discomfort, nausea, and vomiting that may be associated with migraines
• Benign paroxysmal vertigo has brief recurrent attacks of vertigo
• Benign paroxysmal torticollis (head tilt to one side)

Conventional treatments 

Treatment for migraines is dependent on whether the migraine is acute or chronic, such that a migraine occurring once will require acute intervention, whereas chronic or recurrent migraines require prophylaxis (preventative measures). 

Acute treatment involves the use of:

• Simple analgesia (pain relief such as ibuprofen)
• Anti-emetics (medications to treat nausea and vomiting) 
• Triptans (used to constrict blood vessels in the brain and reduce pain and nausea)⁵

Preventative measures also include pharmacological treatments such as:

• Angiotensin II blockers (used to reduce blood pressure associated with migraine pathophysiology)
• Anti-convulsants (used in epilepsy and can help with migraine symptoms)
• Anti-serotonergic drugs (commonly used in depression, but also useful in migraines)
• (used in the treatment of hypertension, but should be avoided in individuals with asthma) 
• Calcium channel blockers (blocks dopamine receptors in the brain to reduce migraines)
• Tricyclic antidepressants (used in the treatment of depression, but can aid in the reduction of migraine symptoms)⁵

Although each of these interventions is commonly used in clinical practice to mediate the symptoms of migraines, there are specific limitations of each that prevent them from providing holistic relief, as well as producing unwanted side effects. 

Magnetic therapy 

The rationale behind the implementation of magnetic therapy in clinical practice is multifactorial. It is a non-invasive treatment that utilises magnetic fields for the relief of a multitude of conditions, as well as having practical utilities in neurophysiology.⁶ 

Types of magnetic therapy safe in the treatment of migraines

Single-pulse and paired-pulse/double-coil TMS are currently the only subtypes of transcranial magnetic stimulation (TMS) that are licensed for use in migraine treatment.⁶ However, based on the limited gold standard evidence of a clinical trial (a randomised control trial), the efficacy of TMS is still underexplored and requires further investigation.⁶ 

Efficacy of TMS 

A meta-analysis of TMS research in clinical trials suggested that TMS is an effective and safe treatment for migraine, especially chronic migraine.⁷ Additionally, this study proposed that TMS may pose as an alternative to pharmacological intervention and other therapies when these have repeatedly failed in symptom reduction.⁷

Safety and side effects

Safety 

Individuals should be aware of the contraindications of having TMS. Any mental implants in the head area (aside from braces and dental fillings) prevent individuals from having this intervention. These include:⁸

• a metal plate or any other foreign metal piece in your head
• implanted devices like a brain stimulator
• metal clips or coils for an aneurysm
• facial tattoos with magnetic or metallic ink

Before TMS treatment, all jewellery and metal on your body must removed, as this intervention utilises magnetic fields and pulses.⁸

TMS is also not recommended for individuals who experience seizures or epilepsy, or anyone with other current medical conditions that have a risk of seizures.⁸

Side effects

It is of significant importance to always check novel treatments with your healthcare professional, as some individuals may not be suitable for treatment with TMS.

The side effects of TMS treatments are commonly minor, however, it is important to comprehend the potential side effects to weigh up the pros and cons of treatment.

Side effects may include:

• nerve twitching or a vibrating sensation around the head and face area
• headache or tenderness after the treatment
• dizziness⁸

Roughly 33% of people experience some headache pain or facial twitching after TMS. The most serious side effect of TMS is a seizure, although this is rare, for instance, if you have a condition that increases your risk.⁸

Summary

The exploration of magnetic therapy in migraine management presents promising avenues for individuals seeking alternative and complementary approaches to alleviate their symptoms. While further research is warranted to fully elucidate its mechanisms of action and efficacy, the existing evidence suggests that magnetic therapy holds potential as a non-invasive, drug-free option for migraine relief.

By harnessing the power of magnetic fields to modulate neural activity and potentially mitigate pain pathways, this therapy offers a safe and well-tolerated option for those who may not find sufficient relief from conventional treatments or wish to minimize medication reliance.

As scientific understanding continues to evolve and clinical trials progress, integrating magnetic therapy into comprehensive migraine care plans may contribute to enhancing patient outcomes and improving the quality of life for individuals burdened by this debilitating condition.