Peripheral neurostimulation techniques for primary headaches

Primary headaches are highly prevalent among the general population. Despite aggressive pharmacologic and behavioral therapies, primary headaches can become refractory leading to a challenging situation for the treating physician. For the past few decades, pain and headache specialists have incorporated the utilization of interventional approaches to the management of acute and chronic headaches with good results. Among these, peripheral neurostimulation techniques have become more popular due to their efficacy and safety profile. The most common sites for which peripheral stimulation can be applied for the treatment of headaches are the occipital, supraorbital and vagus nerves, and sphenopalatine ganglion. However, the evidence supporting these is variable; therefore further controlled studies are needed to standardize their practice. This article provides an overview of the most relevant data on peripheral stimulation in the management of primary headaches.