This month the Migraine Trust issued a press release regarding "corrugator muscle surgery". Wendy Thomas, the CEO for the Migraine Trust, went on record to say that they would not recommend this type of surgery for migraine. The main reason was "insufficient evidence" that this type of surgery is effective.
Some researchers have suspected that there is evidence that this type of surgery may help people because of the way Botox has helped some with chronic migraine. Is Botox impacting the muscles in a temporary way, and if so can surgery make the improvement permanent?
Of course, saying that there’s generally "insufficient evidence" does not mean that this type of surgery never works, and it does not mean that it might not be a promising area of research. But there are some reasons why we can’t jump too quickly onto the bandwagon.
First, we don’t know exactly why Botox works. We can’t assume that we know, because there are a number of complex biological changes happening in Botox treatment.
Second, there has been a very limited amount of research done in this area.
Third, we need to remember that this type of surgery, if it does work in a widespread way, is likely eliminating a trigger, but not a cause. That means that the migraine attacks could return after surgery, even if it isn’t right away.
On the other hand, just because this is not a treatment for the majority of migraine patients at this point, we shouldn’t completely abandon the research. It’s one thing to point out to patients that there are many better options to try, it’s another thing to jump to the conclusion that there is no promise in this area of research at all.
Remember that there are many, many treatments available, and also many, many lines of research in this day and age. This should never be the "only hope" of future treatment for a migraineur.