Transcutaneous electrical nerve stimulation (TENS) for headaches

February 12, 2013

Electrical stimulation of the nervous system is widely used for a variety of conditions and in a variety of ways. The nervous system can be electrically stimulated at the level of the brain, by implanting electrodes into the brain, at the level of spinal cord, also with implanted electrodes or at the level of peripheral nerves in the skin by attaching an adhesive electrode or with an implanted wires. The conditions that can be helped by electrical stimulation range from Parkinsons disease and depression to chronic low back pain and post-herpetic neuralgia (shingles). Stimulation of the nerves through adhesive electrodes temporarily attached to the skin is called transcutaneous electrical stimulation, or TENS. TENS has been proven to help a variety of musculo-skeletal conditions, such as back pain and arthritis pain.

There have been some studies of the use of TENS for headaches, but none of them have been as rigorous and scientific as the one just published in Neurology. The lead author, a Belgian neurologist and a headache specialist Dr. Jean Schoenen and his colleagues conducted a study on 67 patients with a proprietary TENS device called Cefaly. The device is put on the forehead like eyeglasses and it contains electrodes which stimulate the nerves above the eyes. The study showed that by using this stimulator for 20 minutes daily for 3 months patients reduced the number of their migraine headaches from an average of 7 to 5 a month. Those patients who put on the device but were not given electrical stimulation (the sham, or placebo group) did not improve.

The device costs about $368 on Amazon and $240 at Costco in Canada. It is not clear if this device offers any advantages over a TENS unit that costs about $50 and is widely available in this country. Perhaps, Cefaly is much more convenient in that it does not require adhesive electrodes with wires attached to a little box. Another possible advantage is the stimulating current may have specific frequency, strength and wave shape, which provides better relief. However, an electrical engineer could easily hook up the Cefaly unit to a monitor and figure out and publicize these settings. I do not suggest that the people who developed this device and did all the testing do not deserve to be financially rewarded. They may, in fact be rewarded because their device is significantly more convenient and simple to use and many people will prefer it to a more cumbersome device.

Written by
Alexander Mauskop, MD
Continue reading
July 18, 2026
Alternative Therapies
Why Everyone Should Have Their Vitamin D Level Checked, And Why 'Normal' Isn't Good Enough
Vitamin D deficiency is common, often missed, and easy to correct. In this post I explain why “normal” lab values can be misleading, how vitamin D affects headaches, heart and brain health, and what levels and doses I recommend for my patients.
Read article
July 13, 2026
Brain disorders
fMRI-guidedTMS targeting improves outcomes
This post reviews new data showing that fMRI‑guided, connectivity‑based TMS targeting improves response rates in treatment‑resistant depression and likely other conditions. By mapping each patient’s brain circuits, clinicians can move beyond a one‑size‑fits‑all DLPFC target to condition‑specific and patient‑specific sites, a particularly important advance for migraine and network‑based pain disorders.
Read article
July 3, 2026
Alternative Therapies
Essential Oils Can Change Your Brain
The science of essential oils and the brain is still young, but the findings so far are more compelling than many people realize. Brain imaging studies show that common scents like rose, lavender, peppermint, and lemon produce measurable changes in brain structure, brain activity, and pain processing. These studies are small and preliminary, and essential oils are not a substitute for medical treatment. But the evidence suggests that what we smell can influence the brain in real, physical ways
Read article
Insights from Dr. Alexander Mauskop on headaches and migraines
Subscribe to the Blog.
Subscribe
Subscribe