Surgery for Migraines? Here's What You Should Know

If migraine pain and other uncomfortable symptoms are derailing your life, you’re in good company. Globally, over one billion adults, including about 40 million Americans, struggle with migraine disease. 

The pain migraine causes can be severe. And there’s no doubt it can wreak havoc on your day-to-day activities, causing you to miss work and personal events and struggle with sleep. 

Fortunately, at Anthony Echo, M.D., with offices in Houston, Texas, our board-certified surgeon offers surgical decompression to help your migraines. This low-risk, effective surgery reduces or eliminates migraine disease’s frequency, duration, and pain. Here’s what you need to know.     

Migraine surgery 101

Migraine surgery is a type of nerve decompression surgery. It works by easing the pressure on the sensory nerves that trigger your migraine symptoms. 

These trigger points are hyperirritable areas in your muscles that send pain messages along their associated nerves. With migraine surgery, Dr. Echo releases the compression on these trigger points to reduce or eliminate your migraines. 

Not all people with migraine disease share the same trigger points, and you can have more than one. Some of the most common include:

• Frontal (forehead, above eyes)
• Temporal (temples)
• Rhinogenic (nose, behind eyes)
• Occipital (back of the head, across the skull)

There are other less common trigger point sites, but one of these may cause your migraine attacks. Dr. Echo performs a careful examination to accurately diagnose your unique trigger points. 

What to expect during your migraine surgery

The exact time needed for your migraine surgery depends on your unique situation, but normally, the procedure takes about 2-3 hours. You can expect to receive general anesthesia, but the surgery is an outpatient procedure, so you’ll go home the same day. 

Rather than addressing all your trigger points at once, Dr. Echo uses a staged approach, targeting only a few trigger points during each procedure. He generally begins with the occipital trigger points, then assesses your results before scheduling you for additional surgery to address other trigger points. 

During the procedure, Dr. Echo makes an incision and surgically removes the tissue pressing on the sensory nerve and triggering your pain. The incision is then closed, and Dr. Echo moves to the next trigger point. 

Once your surgery is complete, you rest in the recovery area until you’re cleared for discharge.   

What to expect after migraine surgery

Once you’re awake and have met the discharge criteria, you can return home to rest. While everyone is different, Dr. Echo suggests taking it very easy for the first two days after your surgery. You should also plan to take 1-2 weeks off of work as you recover.

As you heal, you may notice some temporary symptoms, including:

• Headache
• Itching
• Tingling
• Soreness
• Numbness
• Bruising
• Swelling

While some people stop experiencing migraine attacks altogether, others may continue to experience them, only less frequently. This could be a sign that you have additional trigger points that require surgical treatment or other migraine therapies. 

It’s important to note that results from migraine surgery don’t appear overnight. You’ll know how well the treatment worked for you after 4-6 months, although many patients notice an improvement much sooner. 

Patients will need to continue to be under the care of a neurologist or pain management physician specialized in the medical management of headache. While the surgery can reduce the severity, frequency, and duration of headache symptoms, patients will still have other sources of headaches, which need to be managed by neurologist. 

Candidates for migraine surgery

Determining whether migraine surgery is right for you is based on your surgeon’s assessment and your personal preference. Trigger point decompression isn’t right for everyone. Generally, good candidates:

• Have been diagnosed with migraine disease by a neurologist
• Have not had success with other migraine therapies
• Are in good overall physical health
• Have realistic expectations about the results
• Be under the care of a headache specialist or neurologist for all pain medications

When you consult with Dr. Echo about migraine surgery, he may recommend a diagnostic nerve block to help determine which nerves are involved, so he can create a personalized surgical plan for your trigger points and the number of sites requiring intervention. 

The surgery is not routinely covered by most insurances at this time. We do try to work with the insurance company, each plan is different. 

To learn more about migraine surgery or to find out if you’re a good candidate for the procedure, schedule an appointment online or over the phone at Anthony Echo, M.D., in Houston.