If you are starting transcranial magnetic stimulation (TMS) for depression and wondering, “Does TMS cause headaches or migraines?” you are not alone. Headaches and scalp sensitivity are among the most common side effects of TMS, and for people like me who are already prone to migraines, the treatments can light up pain pathways that you really don’t want lit up. In this piece, I share exactly what TMS feels like from session to session, where the pain occurs, how long it lasts, and what triggers it (coil position, stimulation intensity, and timing). Most importantly, I’ll outline what really helps: simple TMS headache relief steps, small adjustments your technician can make, and practical migraine prevention settings that keep me going. If you’re looking for real answers about TMS headaches, TMS migraine risk, and how to reduce pain without ending treatment, this is the guide I wish I had on day one.
Go to:
What is TMS? TMS basics you need to understand
Transcranial magnetic stimulation (TMS) is a treatment, often for treatment-resistant depression, that uses strong magnetic pulses to stimulate brain neurons. It is considered non-invasive as there is no need to cut the skin. Essentially, an electromagnetic coil is placed at a specific point (or points) on your head. According to the Mayo Clinic:
This coil delivers magnetic pulses that stimulate nerve cells in the area of your brain involved in mood control and depression. It is thought to activate areas of the brain that have reduced activity during depression.
There are very few side effects other than pain, including headache and migraine pain and dizziness. See here for more.
TMS Headache vs. Migraine: How to Tell the Difference
- TMS headache: localized pain or pressure in scalp/temple monitored with coil position. it usually fades hours after a session.
- Migraine: the palpitations, often unilateral, may include sensitivity to light/sound, nausea, wheezing, and other symptoms and may last longer than the day of treatment.
Drugs and TMS
Keep in mind that some medications can affect the effectiveness of TMS and you may need to withdraw them to give the treatment the best chance of working. There are also some contraindications. More about TMS security can be found here. Be sure to discuss all your medications and supplements with your TMS prescriber and don’t change anything on your own.
TMS “Dosage”.
When you receive TMS, you will have a target ‘dose’ (coil power). This is determined by measuring your motor threshold (how much force it takes at a certain point to make your arm twitch). This number is then multiplied by your “prescription” to determine your goal.
For example, your engine limit might be 40% of full power. Your prescription can be 120%. That means your target is 48% of full power.
When you start each TMS treatment, they will start you at a lower dose (say, 30% of full strength) and work up to your goal, each time increasing the dose you start at.
receive Theta burst TMSa newer type of TMS, which may be more effective. It takes just over three minutes for a TMS depression treatment. (They also do TMS for the anxiety on the other side of my head. This only takes 40 seconds per treatment as the pulses are continuous.) I will receive 30 treatments, one per day, Monday through Friday.
What is TMS for me?
All I’ve ever seen said about TMS is that “mild discomfort” can be felt. That’s not what I found. I’ve found the “discomfort” to be talking to a doctor about the pain — the only question is how much.
I suffer from chronic migraines and without going into medical details, let’s just say that I deal with head pain every day right now. And, unfortunately, the TMS treatments make my head pain worse.
For me this happens:
- I sit in the TMS chair and they place the coil appropriately using markings on a tight cap on my head.
- Arousal begins and pulses and pain produce a scary answer. This increases my anxiety.
- The pulses feel like being hit in the head with a long, thin blade. Pain shoots through my scalp, brain, eyes and jaw.
- The pain is just, just bearable.
- There is a break in the pulse. When they start again I get another scary reaction and the pain is worse (because the dose has been increased).
And so it goes for a little over three minutes. And while three minutes sounds very short, it feels very long thanks to this pain. At the end of the treatment, I have a migraine and feel tired and nauseous. Doctors say headaches are short lived after treatment, but that’s not my experience. I have one for the rest of the day.
Please understand, none of this is to scare you. This is just my experience and yours may vary dramatically. I consider myself lucky to have access to this treatment and hope for its success. I think it could help a lot of people who have few options. No doubt, if it works, the pain will be worth it.
What makes TMS pain worse?
The first TMS treatment was horrible, probably because of the high degree of stress involved in the treatment. The second treatment was somewhat less difficult.
Additionally, in my experience, I have found a few things that make TMS pain worse. They include:
- Starting with a headache (this can be a full-blown migraine or just a headache)
- He is prone to migraine or headache
- Entering with great anxiety
- Tightening your muscles
- Illness (I had COVID and it increased the pain dramatically. I was told this is due to inflammation caused by illness)
- Lack of sleep
Some of these factors are modifiable and some are not.
What helps TMS pain for me
Addressing pain exacerbating factors, where possible, can help reduce TMS pain. For example:
- Taking headache medication before treatment to try to minimize the pain that occurs. (Be sure to check with your clinician that any medication you choose to take will not interfere with the effectiveness of TMS treatment.)
- Focus on staying calm during treatment.
- Sleep as much as possible.
The specific techniques I use during treatments include:
- Rubbing the spot on my head where the stimulation will take place to try and relax the muscles as much as possible.
- Chit-chatting with the technicians beforehand to help ease the stress.
- Focusing on something positive instead of the upcoming pain.
- Using a mantra. (Mine is, “I’m a skydiver. I can do anything.“)
- Focusing on deep, slow breaths during treatment.
- Focusing very specifically on relaxing all the muscles in my head during the treatment (including between pulses).
If you experience pain during TMS, you can talk to the technicians and they may be able to move the coil slightly or adjust the dose or ramp up to relieve it. Also, keep in mind that you may find the pain more bearable with repeated treatments.
Finally, technicians tend to provide feedback during treatment, such as when I’ve reached my target dose, how long I have to go, etc. I find this very useful and would suggest requesting it if it is not already given for free.
But does TMS really help depression?
I have treatment-resistant depression (also known as “difficult to treat”). And “difficult to treat” is an understatement. I have tried every combination of every medication imaginable, years of therapy, modified lifestyle factors, plus vagus nerve stimulation (VNS) and electroconvulsive therapy (ECT). I am the poster child for treatment resistance.
That said, I have high hopes. Most people who get TMS have some degree of resistance to treatment, and the success rate seen in the clinic has been remarkable. The vast, vast majority of people experience improvement. It’s not guaranteed to work for anyone, but it’s promising.
For me, I’m only 11 TMS treatments in, so it’s a little early to tell. I have hopes though.
Frequently asked questions about TMS headaches and migraines
Common; Many report early mild to moderate scalp pain that may improve over time.
It says they should last “a while” but I’ve found they last the rest of the day or maybe even the next day.
Often yes, but ask your prescriber (eg, schedule for triptans, over-the-counter pain relievers, anti-nausea meds, etc.).
TMS headaches and migraines without derailment therapy
The bottom line is that TMS headaches and scalp pain are common, and if you’re migraine prone like me, treatment days can cause greater symptoms. The good news is that most people find the pain manageable and often improves over time, especially with a plan. What can help is a combination of clinic adjustments (such as a gentle increase in target dose, reinsertion of a small coil) and patient strategies (such as proper sleep, calm breathing, mantra use, and clinician-approved medications). If you’re starting TMS for depression and wondering if TMS side effects like headache or migraine mean you should stop, talk to your team first: small tweaks can make a big difference, and many patients continue successfully with the right TMS headache relief approach.
