February 06, 2026 | Headache Surgery
4 minute read
Choosing a surgeon for your headache operation is an important decision.
Here are five things you need to look for when selecting your healthcare team:
- One of the first things to assess is whether your surgeon has formal and specific training in peripheral nerve surgery. Since the operationS for chronic headaches/neuralgia potentially involve many nerves within the peripheral nervous system, the person performing such operations should have had focused training on the workup, evaluation, and management of patients with any number of peripheral nerve problems (chronic headaches included). Because peripheral nerve surgery is performed on all parts of the body (e.g., arms, legs, trunk, and head), your surgeon should ideally have experience and training with many of these types of nerve procedures because they provide the procedural foundation employed in the operations designed for chronic headaches/migraines.
- Another important thing to ask your surgeon is how many of these specific headache procedures they have performed. In addition to the overall number of cases s/he has performed, the surgeon should also have experience with the variety of peripheral nerves known to be potential causes of chronic, severe headaches. These include nerves within the forehead, temple, and occipital regions as a few examples. For example, a question that a patient might ask is, “What percentage of your [the surgeon’s] practice is focused on peripheral nerve surgery?” If the majority of the surgeon’s practice is devoted to peripheral nerve surgery, they likely have the necessary experience to treat your condition.
- Is your surgeon a member of the American Society for Peripheral Nerve (ASPN) and the Migraine Surgery Society (MSS)? The ASPN is the leading academic society for peripheral nerve surgeons.
Its mission is to stimulate and encourage study and research in the field of neural regeneration, to provide a forum for the presentation of the latest research and relevant clinical information and to serve as a unifying authority on all areas of neural regeneration and restorative neuroscience. In order to become a member of the ASPN, a candidate has to be nominated by two of their peripheral nerve surgical peers and have published at least one scholarly, peer-reviewed paper on some aspect of peripheral nerve surgery. The Migraine Surgery Society (MSS) is the premier think-tank of experts that define and shape the field of migraine surgery. It is a forum for physicians, patients and researchers interested in headache/migraine surgery with the goal of encouraging a dialogue between groups, exchanging clinical experience, and collaborating on research. In order to become a member, one has to have experience in the field of headache/migraine surgery and letters of support from established headache/migraine surgeons. Dr. Peled has served in several roles for this Society, most recently as President. Looking for MSS and ASPN membership can serve as objective vetting factors in deciding between headache surgeons. 
It also demonstrates a true commitment to the study of peripheral nerve problems and a genuine interest in advancing this field. Look for the MSS and ASPN logos on your surgeon’s website. Dr. Peled has been a member of these Societies for many years, has published and continues to publish papers and lecture both nationally and internationally on various aspects of headache and peripheral nerve surgery. Recently, he co-edited a textbook devoted to headache and migraine surgery (https://link.springer.com/book/10.1007/978-3-030-36794-7). Dr. Peled has also served on several MSS and ASPN committees and moderated numerous scientific sessions at the Annual Meetings. - Your surgeon should also be able to provide you with references for the type of procedure(s) he or she is recommending. Not only does this give you the chance to speak with someone who has gone through what you will likely experience, it demonstrates that the surgeon has actually performed the procedure at least once before.
- Finally, you should choose a surgeon with whom you have a good rapport. This is the hardest concept to describe or discern. While there are relatively few surgeons who perform these operations with any frequency, patients must realize that there still may be several qualified surgeons technically capable of performing the right operation for the correct indications. However, just like every patient is different, so is every surgeon. Is their office staff professional and pleasant? Does the doctor answer your questions in a manner that you can understand and make you feel at ease that they understand your particular situation? Do they spend time actually listening to you and your symptoms? Are they realistic in setting your expectations for what will happen before, during, and after your procedure? These factors can make the difference between simply a good outcome and a good outcome with a good experience along the way.
