Introduction

Therapeutic ultrasound or ultrasound therapy is a procedure that uses ultrasound waves to stimulate tissues which helps in many conditions. Ultrasound therapy uses sound waves instead of electrical stimulation. It is normally used in physiotherapy to reduce pain, increase blood flow, reduce swelling and facilitate healing.¹

Migraines are a specific type of headache.⁸ Most drugs used for both headaches and migraines are analgesics, also known as painkillers. The chronic use of certain painkillers is harmful to health hence alternative methods to relieve pain are an important goal for researchers.^2,3

The use of ultrasound therapy for headaches and migraines is relatively new and the research is ongoing. Patients can find specific centres that provide this service. 

In this article we will discuss how ultrasound therapy is a potential treatment modality for migraines and headaches.  

How it works

In most places that provide this service, these steps are followed:

A trained professional keeps an ultrasound device on the head (different parts for different types of treatment). Sound waves travel into the tissues through the skin. They cannot be heard as they’re high frequency and out of the human hearing range. The whole procedure feels like a warm massage. The increase in blood circulation helps with the pain and reduces the frequency of migraines and headaches. A healthcare professional can tell if a person is eligible for such a treatment. Ultrasound therapy is also used for specific nerve entrapments that can also lead to headaches.^1,4 

Types of Ultrasound Therapies

There is no official use of ultrasound therapy for headaches and migraines but there are many types of ultrasound therapies used in research models and at some specific centres. Ultrasound therapy is non-invasive so there is no harm (unless contraindicated by a healthcare provider) to using this method if available.^2,3,4 The types commonly used are:

• Focused ultrasound therapy (high intensity or low intensity)
• Static ultrasound therapy
• Low-intensity transcranial ultrasound stimulation
• Non-specific trigeminal nerve stimulation 
• Other specific nerve stimulations like vagus nerve, occipital nerve, etc.

Types of headaches treated

There are various types of headaches and migraines. Research has shown that some of them can be treated using ultrasound therapy. They are the following:

• Cluster headaches
• Migraines
• Tension headaches
• Cervicogenic headaches

Other treatment methods used

Migraines and headaches have various medications used to alleviate the pain and reduce the frequency. Some examples are given as follows:⁵

• Analgesics: Ibuprofen, Sumatriptan, Zolmitriptan, Naratriptan, Almotriptan, etc.
• Preventive drugs: Beta blockers, Tricyclic antidepressants, MAOIs, etc.
• Avoid migraine triggers like: bright lights, certain food items, etc. 

Importance

Even though the research is still going on, ultrasound therapy could be the key to finding non invasive ways to treat migraines and headaches. Many forms of migraines and headaches do not subside with painkiller use and occur frequently enough to disturb the patient’s life. Ultrasound therapy can reduce the frequency and duration of the headache and improve the quality of life. Most commonly the research focuses on occipital nerve stimulation.^2,3,4 

Some researchers believe that ultrasound therapy has a potential to cure resistant migraines. 

Unfortunately, most of these studies have their limitations, such as: small sample size, and lack of follow up in the long term. More research needs to be done to confirm the current findings and to use this treatment modality instead or in combination of the original ones. In conclusion, ultrasound therapy has a high potential to be a non invasive, pain free method to treat migraines and other types of headaches.^6,7

Areas of further research

More research can be done on ultrasound therapy by:

• Targeting specific nerves and/or areas of the head
• Change the dosage and timings
• Larger sample size
• Long term follow up with the patient
• Portable and affordable devices

Summary

Therapeutic ultrasound, a procedure using sound waves instead of electrical stimulation, has become an important consideration for treating migraines and headaches. Commonly employed in physiotherapy to alleviate pain, increase blood flow, and facilitate healing, ultrasound therapy presents an alternative to chronic painkiller use, which can be detrimental to health. While still a relatively new approach, ongoing research explores its potential in addressing various headache types. 

The procedure involves a trained professional placing an ultrasound device on different parts of the head, with sound waves penetrating tissues and creating a warm massage-like sensation. This therapy, also used for specific nerve entrapments, holds promise as a potential treatment modality for migraines and headaches. 

Although no official endorsement exists, various ultrasound therapies, including focused, static, and low-intensity transcranial ultrasound stimulation, show potential benefits. Research indicates effectiveness against cluster headaches, migraines, tension headaches, and cervicogenic headaches. Despite ongoing studies, ultrasound therapy could provide a non-invasive means to enhance the quality of life for individuals whose headaches resist conventional painkiller treatments. 

Occipital nerve stimulation is a primary focus of current research, with potential applications for curing resistant migraines. However, studies' limitations, such as small sample sizes and inadequate long-term follow-ups, underscore the need for further research. Areas for future exploration include targeted nerve and head area treatments, dosage and timing adjustments, larger sample sizes, and the development of portable, affordable devices. 

In conclusion, ultrasound therapy holds significant potential as a non-invasive, pain-free method for treating migraines and various headaches, pending further research and refinement of its applications.

FAQs

Which kinds of headaches can be treated with ultrasound therapy?

Research suggests potential benefits for various headaches, including cluster headaches, migraines, tension headaches, and cervicogenic headaches.

Is ultrasound therapy safe for everyone?

While generally considered safe, eligibility depends on an individual's health condition. A healthcare professional can determine suitability based on a thorough evaluation.

Are there side effects associated with ultrasound therapy for headaches?

Common side effects may include a warm sensation during the procedure. However, complications are rare, and adverse effects are generally mild and temporary.

How long does a therapeutic ultrasound session typically last?

The duration of a session can vary, but it is generally a relatively short and well-tolerated procedure.

Is it available as an option in all hospitals and medical centres?

No, it needs more research to be widely available but some private centres provide this as a service.