If you’ve ever had a migraine, you know it’s not “just a bad headache.” It’s more like your brain has staged a tiny, extremely dramatic protest, complete with lighting effects, sound sensitivity, and the kind of nausea that is usually part of a well-earned hangover.
So when people hear “TMS can help migraines,” the natural reaction is: Wait… the thing used for depression can help my headaches? Potentially, yes, depending on the type of migraine and the specific TMS approach.
Let’s break down what TMS is, how it works in general, why it may help with migraines, and what the research says.
TMS stands for Transcranial Magnetic Stimulation. It’s a non-invasive technique that uses magnetic pulses to influence brain activity. Non-invasive is the key phrase here: no surgery, no implants, no medications or their side effects.
A TMS device generates a focused magnetic field near the scalp. That magnetic field induces a small electrical current in the brain tissue underneath, basically nudging certain networks to become more or less active.
There are a few types of TMS commonly used in mental health:
And yes, this is the same “TMS” family many people know from depression treatment. But migraine and mood share a lot of overlap in brain circuitry than most people realize.
The simplest way to think about it:
Depending on how pulses are delivered (single vs repetitive, frequency, intensity, timing), TMS can:
In depression, for example, rTMS is often used to modulate networks involving the dorsolateral prefrontal cortex. In migraine, researchers have explored targets and patterns more tied to sensory processing, pain modulation, and migraine-specific brain dynamics.
Migraines involve multiple systems, but two concepts matter a lot for TMS:
In migraine with aura, a leading mechanism is cortical spreading depression, a wave of altered brain activity that moves across the cortex and is associated with aura symptoms (visual changes, tingling, speech issues, etc.). CSD can also trigger downstream pain pathways.
Migraine pain is strongly linked to activation of the trigeminal nerve system and associated blood vessels and inflammatory signaling—often called the trigeminovascular system.
The short version: migraine is a brain-state problem, not simply a “my head hurts” problem.
Single-pulse TMS (sTMS) has been studied as an acute treatment, meaning you use it when a migraine starts (often at aura onset). The idea is that a well-timed magnetic pulse may disrupt the progression of cortical spreading depression, potentially stopping the cascade before pain fully blooms. A major randomized trial discussed in The Lancet Neurology found that sTMS improved pain outcomes in people treating migraine with aura compared with sham stimulation. This matters because migraine attacks can be stubborn: once that cascade gets going, it’s like trying to stop a runaway shopping cart with a gentle whisper.
For prevention, research has explored repetitive TMS (rTMS) – delivered in sessions over days or weeks – aimed at reducing attack frequency or intensity over time. Trials and reviews suggest rTMS may reduce migraine days or attack frequency for some people, though protocols vary a lot (targets, frequencies, number of sessions), and results aren’t perfectly uniform across studies. Meta-analyses have attempted to synthesize these results and generally find rTMS shows promise, with ongoing work needed to refine “best” settings.
Translation: the science is encouraging, but we’re still in the “figuring out the best recipe” stage rather than “grandma’s definitive chocolate chip cookie” stage.
For most people, TMS feels like:
Side effects tend to be relatively mild in many studies (things like scalp discomfort or transient sensations), but individual experience varies, especially in migraine, where the nervous system may already be feeling dramatic.
People often start exploring TMS for migraine when they’re looking for something different from the usual medication-first approach. This is especially true for individuals with migraine with aura who want an acute, non-drug option they can use early in an attack, before the pain fully takes hold. Others turn to TMS because certain medications haven’t worked well for them, caused side effects they’d rather not repeat, or simply aren’t a good fit because of other health considerations.
And for many people, TMS isn’t about replacing everything else… it’s about adding another tool to a broader migraine strategy that already includes things like improving sleep, managing stress, identifying triggers, and using preventive treatments when appropriate. As with any migraine treatment, the most important next step is a thoughtful conversation with a clinician who regularly treats migraine and understands neuromodulation options, so the approach can be tailored to the individual rather than the diagnosis alone.
Migraines are complex. That’s frustrating… but also hopeful, because it means there are multiple angles of attack, including medications, behavioral strategies, lifestyle supports, and increasingly, non-invasive neuromodulation approaches like TMS. It might not be everyone’s miracle button, but research suggests TMS could be a meaningful part of migraine relief.
