Airflow into the nose can be used to stop the pain of a migraine
A blast of air into the nose can relieve migraine pain in just 15 minutes. The technique works by cooling nerves at the back of the nose that are involved in generating severe headaches.
The results of a small trial, presented at the annual meeting of the American Headache Society in Austin, Texas, in June, showed that nearly half of those who received the air jet treatment were pain-free afterward.
Others received significant, though not complete, relief.
Most people who suffer from migraines rely on pain relievers or prescription drugs called triptans, which can shorten the duration of the attacks.
A new class of drugs called CGRP inhibitors may prevent the attacks in the first place.
They are given as a jab in the stomach, arms or legs, but are expensive (several thousand pounds a year) and are strictly limited to people who suffer from severe migraines at least once or twice a week.
Most people who suffer from migraines rely on pain relievers or prescription drugs called triptans, which can shorten the duration of attacks (stock image)
The new treatment targets a bundle of nerves behind the nose called the sphenopalatine ganglion, or SPG.
The SPG is connected to the trigeminal nerve, which provides sensation in the face: when the trigeminal nerve is overstimulated by triggers such as hormonal changes, alcohol, caffeine, or stress, it triggers migraines.
The SPG is responsible for sending the pain signals to the nervous system and brain. In very severe cases, doctors sometimes inject anesthetic through the nose into the SPG nerves to numb them so they cannot send the pain messages (a procedure called an SPG block).
But the pain relief may only last for a few weeks, and the injection may cause nosebleeds, lightheadedness, and a numbness in the back of the throat. The latest technology could be a simpler alternative.
It’s based on a process called transevaporative cooling, a technique already being explored by some scientists as a way to cool the brain — and reduce the risk of injury — when someone goes into cardiac arrest.
For the new migraine treatment, the patient puts on a mask and then dry air (air from which all moisture has been removed) is pumped into the nostrils.
As the air passes over soft tissue surrounding the SPG nerves, it causes tiny moisture particles on the surface to evaporate.
This cools the nerves, because the process of evaporation consumes energy from the body: less energy means less heat.
In animal studies, the cooling effect has been shown to interrupt the transmission of headache pain signals.
A blast of air into the nose can relieve migraine pain in just 15 minutes. The technique works by cooling nerves at the back of the nose involved in generating severe headaches (stock image)
In a preliminary trial, researchers from the Department of Headache and Facial Pain at Michigan State University in the US tested the treatment on 24 migraine patients.
Recruits were told to report to the university’s research center as soon as they felt a migraine coming on – they then underwent the nasal air jet treatment, using a machine called the CoolStat Transnasal Thermal Regulating Device.
The results, which have yet to be published in a peer-reviewed journal, showed that nearly 90 percent of patients experienced significant pain relief two hours after treatment, with nearly half reporting complete pain-free, some within 15 minutes.
The researchers now hope to shrink the device so that patients can use it at home.
Dr. Andrew Dowson, clinical lead at NHS East Kent and Bromley Headache Services, said: ‘The results are encouraging and this is a simple approach with little risk of unwanted side effects. But at the moment the number of patients on which it has been tested is too small to demonstrate the effect.’