April 02, 2021

Nerivio Device Treats Migraine Headaches WITHOUT Medication Use

There have been a number of new FDA approved devices to treat a variety of ailments without the need for medications using microelectronic stimulation. Such devices include ClearUp to help alleviate sinus congestion and sinonasal allergy symptoms as well as eXciteOSA to resolve snoring or mild OSA in select patients. Now there is a fascinating new FDA approved device called Nerivio that help resolve migraine headache attacks via microelectronic stimulation using an armband. No kidding!

The only reason why I as an ENT am involved with migraine headaches (which is really a neurological issue) is because MANY patients who present to an ENT office complain of sinus headaches which actually end up being due to migraines!

In any case, Nerivio was evaluated in two main clinical studies (see references below). The first study was a prospective, double-blind, randomized, crossover, sham-controlled pilot study and the second study was a multi-center, prospective, randomized, double-blind, sham-controlled pivotal study. Both showed migraine headache relief within 2 hours in over 65% of patients without the use of any medications. 

At this time, Nerivio is indicated for acute treatment of migraine with or without aura in patients 12 years of age or older. It is a prescription use, self-administered device for use in the home environment at the onset of migraine headache or aura to help those who do not respond to migraine medications, have unacceptable side effects with such medications, or those who wish to avoid taking medications.

This devices works using a smartphone app available for free download which controls the device wirelessly. The device itself stimulates small nerves in the upper arm. The message from the arm is received by a brainstem pain regulation center that can inhibit pain signals by releasing neurotransmitters, resulting in significant pain relief which can end the migraine attack. With headache onset, the user places the armband with the device flush against the skin. Set the treatment intensity level so it feels strong yet comfortable and painless by touching the ‘+’ button in the app. The device is good for 12 treatments of 45 minutes and once those treatments are completed, the device should be disposed of according to the instructions. 
 
Nerivio IS covered by insurance but requires a doctor's prescription. Per reports, copays can be $10 or even lower (more info)!

For more information, click here.
 
References:
Nonpainful remote electrical stimulation alleviates episodic migraine pain. Neurology Mar 2017, 88 (13) 1250-1255; DOI: 10.1212/WNL.0000000000003760

Remote Electrical Neuromodulation (REN) Relieves Acute Migraine: A Randomized, Double‐Blind, Placebo‐Controlled, Multicenter Trial. Headache. Volume59, Issue8. September 2019. Pages 1240-1252

Remote Electrical Neuromodulation for the Acute Treatment of Migraine in Patients with Chronic Migraine: An Open-Label Pilot Study. Pain Ther 9, 531–543 (2020). https://doi.org/10.1007/s40122-020-00185-1.

Remote electrical neuromodulation for acute treatment of migraine in adolescents. Headache. Volume61, Issue2. February 2021. Pages 310-317


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Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.


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