There has been plenty of PR and news about the Star Trek looking TENS device from Cefaly but I haven’t seen an in-depth Cefaly review from the patient perspective. After much discussion within the MigrainePal community about the device I decided to try one and share my journey with everyone as I went along. The goal is to review the device from an honest perspective. To evaluate what all the fuss is about and whether the Cefaly device is something worth considering given its price tag of around $349 USD all up.
The Cefaly device is a type of TENS unit.
T.E.N.S. stands for transcutaneous electrical nerve stimulation. Sounds scary but the device has been approved in the US, UK, Austalia & Canada by health regulators as a medical device to help treat and prevent migraine.
Side effects are reportedly minimal, the instruction manual cites there is a tendenacy towards sleepiness but otherwise little else. This side effect would be welcomed by many during a migraine attack. They do mention however that 3% of people may be hypersensitive to electricity and therefore are not able to use the device.
The device is supposed to be used for a minimum of 20 mins a day to help prevent migraines. Although there are 2 other settings you can use one for treating an acute attack and another program for stress and anxiety.
In the manual, it does suggest that Cefaly is most beneficial when pain is located in the front half of the skull. Cefaly doesn’t have any proven benefit for pain located at the back of the skull or the lower part of the face, below the eyes.
Personally, I suspect my migraine attacks are heavily driven by a shoulder injury and from my neck but I still do get pain and tension headaches in the front part of my head so I’m still hopeful this will help.
I’m also working way too many hours these days, so anything that can help manage stress or force me to take a 20 minute time oevery dayday is a good thing.
The manual claims that a “state of deep relaxation and an unprecedented sense of well-being are generated through deep muscle relaxation and a marked increase in endorphin secretion”. Sounds nice…
Given that I’ve meditated on and off for the last 9 years I know what that could feel like. I’ve also been to a day spa. So they have certainly set a high benchmark in my mind. Let’s see if they can deliver.
What to expect before you try it
The expected results will vary by individual according to Cefaly. The more consistently you use the device the better.
The program I’m going to aim for is the migraine prevention. The best responders experience an improvement within just a few weeks. Others respond more slowly and may need a few months to see significant improvement.
My migraine attacks are at about 1 per month – but if I stop managing myself or come off my medications they could easily be 1-2 a week or more. At its worst I was getting 5-6 attacks a week. So I’m keen to see if this can help increase my migraine threshold, reduce my attacks and help me come off heavy medications.
That’s the goal. Let’s see what happens…
20 mins later after my first use
After reading the manual and expecting a strange sensation I still wasn’t quite prepared for what occurred.
After following the instructions and sticking an electrode to my head I began the session. There was two minutes of a gentle build up. A few pins and needles. No major drama.
I had read in the manual that the intensity of the device increases gradually for the first 12 minutes. So I set my timer on my phone so I could see if I could go the full strength first go and off I went.
You can easily stop the increase in the intensity and or end the session at any time but I wanted to see how far I could go. Afterall the more sessions you have at full capacity the better according to the manual. And the pain is largely pschyological it explains.
I made it past the 12-minute mark. But it didn’t feel like it leveled out in intensity. I would not describe the discomfort anywhere near the same level of pain as migraine. So don’t worry about that. But at times it can be uncomfortable. I certainly couldn’t carry on doing normal tasks (this does get better as you use it over time).
To describe the sensation. It felt like someone was combing my hair with a heavy metal comb. Whilst putting weight on their other hand pressing down in the middle of my forehead. Mixed with a flurry of pins and needles.
How did I feel afterwards?
Pretty good. Right after it stopped I felt great. It’s similar to the feeling of finishing a long race. It’s a feeling that’s half achievement half endorphin release in your body because you’re so happy you’ve just finished what you were doing.
30 minutes later and my head is still a little numb and tingly.
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After 11 days
On my third day I was feeling fantastic and reading my laptop in bed, I hadn’t eaten or taken my preventatives yet which I usually take first thing and my neck was in a bad position. And I promptly gave myself a migraine after an hour.
Sounds silly in hindsight, but it’s so easy to do. Apart from that self-inflicted attack I’ve felt pretty good.
I’ve definitely noticed a difference. Particularly in relation to “brain fog”. Whether this is a side effect from my medication or the migraine itself is hard to tell, but regardless, the Cefaly device is noticeably helping with this.
It is also helping with my sensitivity to light to a certain extent.
So with 11 days gone, I’ve made one silly mistake, but also seen some promising results. I’ll ensure I continue to use the device at least for another month continuously. And I definitely won’t be reading the laptop in bed again, no matter how good I’m feeling.
After 75 days
It’s now been 2 and half months since I’ve been using the Cefaly device. Am I cured? Nope. But hey, did you really expect that to be the case?
Has it helped? Yes.
Should you go out and buy one? Well, before you go out and spend a few hundred dollars, it’s worth understanding what you’re in for.
Rarely are things so simple with migraine.
What I did with the device over the past 2 and a half months:
- I’ve used the device whilst doing breathing exercises & meditating. It’s great with that.
- I used the device whilst working on the computer, watching TV, eating dinner, brushing my teeth. Ok.
- I’ve accidentally fallen asleep with it and woken up with electrode still attached to my forehead the next morning and the device buried in my bed. Not so good.
I think it’s safe to say I have stress-tested the device.
Falling asleep with the device is a not a good idea. You can damage the device itself and rapidly wear out the electrode. The electrodes need to remain in good order to function properly. They are replaceable but not super cheap (3 for $25 USD).
Over the last few months the benefit from the Cefaly device has become clearer. All else being equal, for me it delivers approx a 30% improvement to my overall migraine baseline.
What does 30% baseline improvement mean?
To provide a little background, on a given day I objectively measure my migraine risk, or my migraine vulnerability. It’s like evaluating how tired you feel on a particular day, except it’s for your migraine condition.
This helps me evaluate my condition everyday, not just when I have an attack, as I may only have 1 or 2 attacks in a given month (down from over 15). But I still notice my condition most days.
In one month I might feel great the whole time. Another month I might feel on edge. I’ll experience vertigo, moodiness, light sensitivity, numbness or coloured spots – all of which would cause my me to rate my migraine risk higher throughout that period.
So ‘migraine risk’ is an important indicator which I track daily. I also use it to help evaluate the effectiveness of any new treatments like the Cefaly device and uncover potential triggers.
My expectations were not high. After reading that the device only helps with the front part of the upper head from the eyes to the top of the forehead, I was pleasantly surprised by the early results which were largely sustained over the last few months.
But, over the last 2.5 months, I’ve had 3 migraines whilst I’ve been using the Cefaly device. While, this is great versus my long term average, this is higher than my usual baseline of one every 2-3 months.
The chart below shows my Migraine risk in with the blue bars. My 3 migraine attacks in orange. And my numerous triggers lines alongside them. Overall – not fantastic. I experienced moderate (medium) levels of migraine risk consistently over the last few months.
Here’s what happened
I got busy.
Work started to creep into the weekends. But I decided to let to that continue as I thought I could handle it because the Cefaly device was working.
I was spending more time under fluorescent lights because of work. Working from a laptop and not a monitor meant that my neck was constantly flexed downward at the screen. This created a poor posture when my neck was already an identified trigger for my migraine condition. Not ideal.
I also stopped meditating. With less time on my hands something had to give I and simply didn’t keep up the discipline.
I also had a wedding and 2 other events were I drank alcohol and missed several nights of good sleep.
So with my system loaded with a higher level of stressors than average then topping it off with alcohol and a lack of sleep – it all caught up with me.
From the graph you can see that I have 3-6 triggers which can flair up. When they jump up together, you’ll notice the result is a migraine as you can see on the chart. I can withstand one or two triggers flaring up. But not much more than that.
Now of course, writing this down it all seems fairly obvious in hindsight. But that’s the problem.
It’s hard to see the full picture when you’re in the frame.
I’ve been actively researching and self-managing migraine for years in partnership with my doctor and I still put myself into silly situations like this. But at least having this record I can see clearly what I’m doing and its impact.
The Cefaly device is helpful and worthwhile. And I still use it everyday. But it’s no cure. It’s not a miracle worker. You can’t use it as an excuse to go back to all your bad habits.
If you’re complacent about your condition, Cefaly won’t save you. Just as other treatments probably won’t.
Cefaly works best when you keep up your self discipline and do the obvious things that someone with migraine needs to do to keep their condition in check. Get the right balance of rest, relaxation, exercise and work. And make sure your diet is on track.
To get the best results from the device, I use the device whilst doing breathing exercises or meditating rather than watching TV or doing other activities.
It’s worth mentioning that the device connects to electrodes that stick onto your head. This sounds strange. It’s not once you get used it. You stick a triangular band-aid looking electrode with a tiny handle, which acts as a small latch for the Cefaly device to attach to.
Because these attach to your skin directly, they eventually lose their adhesiveness. You get approx 20 sessions out of them. So they need replacing. A little annoying.
Make sure to clean your forehead, ideally with alcohol before applying the electrode to help prolong it’s life. I often use a skin moisturiser after use to prevent drying out my skin.
Prices updated 2 August 2018.
In the US the device itself is $349 with shipping typically $29. A 3 pack of electrodes is $25 with an additional $5 for shipping.
Renting a Cefaly device
The device itself can also be rented to trial this treatment option. This might be a suitable approach to if you are unsure about whether the device will deliver results or if you don’t have the full funds available upfront.
Where to find Cefaly devices
Prices as at 31 March 2016:
- USA www.cefaly.us for $349. You’ll need a copy of your prescription before they’ll send you a device.
- Australia – www.cefaly.com.au $299-399 AUD depending on which version you buy. Make sure you check your health plan for rebates as you could get more than $100 back. Cefaly devices can also be rented from www.cefaly.com.au
- UK www.cefaly.co.uk for £249 pounds for Cefaly II and an additional £19 for electrodes. Shipping not included.
- Canada www.cefaly.ca for $349.99 Canadian dollars plus $29.99 for electrodes. Shipping not included.
After 18 months of use
Time has flown. It has now been 18 months since my first review of the Cefaly device and I still have my device and yes, I still use it.
I have to confess I’m not a daily user like I used to be. I did use it daily or very consistently for around the first 12 months. I did notice an improvement and an improvement in my migraine threshold or resilience. But I do feel like my results reached a plateau at this new improved level after this time.
Having said that, if I get a migraine attack or if I begin to feel vulnerable, I pull out the device and start using it everyday until I go back to my usual ‘low vulnerability’ baseline.
I’m glad I have the tool and have not noticed any unwelcomed side effects.
Cefaly, The New, Smaller & Improved Device
Late in 2017 Cefaly introduced a new, smaller and more advanced version of it’s device.
Coinciding with this new device was the FDA approval for Cefaly to be used as an acute treatment device for migraine.
The inventor of the device and CEO of Cefaly, Dr. Pierre Rigaux said: “We are excited that we can now offer migraine patients several drug-free options in their migraine care… We have developed a way for migraine patients to stop a migraine and prevent a migraine without medication and with next-to-no side effects.”
This new approval was based on a double-blind randomized placebo control trial that was presented at a recent meeting of the International Headache Society. The findings showed that on average, the Cefaly treatment reduced migraine pain by 65%. In addition, 32% of patients were pain-free within an hour. (1)
There are now three treatment options: Cefaly PREVENT, a prophylaxis treatment; Cefaly ACUTE, a rescue treatment, and Cefaly DUAL, a device that combines both prevent and acute technologies.
Despite these new settings the device is used in the same way as before. It uses a magnetic connection to a self-adhesive electrode which send micro-pulses through the skin to the upper branches of the trigeminal nerve to relieve an attack of help prevent future attacks.
Are you planning to try it? Has your experience with the Cefaly device been good or bad?
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