Can Surgery Cure Migraines?

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A new study claims that surgery — plastic surgery, no less — has the potential to cure migraines. Of 49 patients who underwent the new treatment (similar to a traditional forehead lift), more than half reported their migraines were completely gone — eliminated. In total, 83% said their migraine frequency had declined by at least half.

Many researchers believe that migraines are caused by irritation of an area of the head called the trigeminal nerve branches. The new surgery, described in the journal Plastic and Reconstructive Surgery removes some of the muscles, or “migraine triggers,” that are around these nerves. This supposedly relieves the painful irritation, and reduces forehead wrinkles too.

Astute readers, of course, will know pain treatments almost always seem to have an effect. Pain is the symptom that’s most responsive to the famous “placebo effect” — a patient’s tendency to feel better after treatment, even when the treatment is totally bogus. But the researchers behind this migraine-surgery trial actually did have a control group: Another 26 patients were randomly assigned to receive a sham surgery that did not target their migraine trigger sites. One year later, only one of those patients (4% of the group, compared to 57% in the intervention group) claimed that their migraines had stopped entirely. A further 57% did claim to have a 50% reduction. But there, again, is that well-known placebo effect.

Could this really be the answer that migraine sufferers are searching for? I bet the American Society of Plastic Surgeons hopes so. Nearly 30 million Americans, including 18% of U.S. women, get migraines, and they spend billions of dollars each year on treatment. But this is still a tiny trial, and I expect the procedure will be tested many times in larger groups before it really takes off.

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