Should You Use an Ice Pack for a Headache or Migraine?

“Cold Therapy” Is a Common Measure

… and an old one: Cold therapy as a migraine relief measure was first documented as early as 1849. 1

Today, even go-to sources for migraine advice such as the National Headache Foundation and the Mayo Clinic include cold compresses and ice packs among their recommendations to ease migraine symptoms.

In fact cold therapy has been cited as the most common self-administered pain-relief measure used by those suffering from migraine without aura and the second most common measure applied by those experiencing migraine with aura. ²

However, there are few clinical studies on the use of cold therapy in migraine, and exactly how cold works to ease a migraine remains poorly understood. Further, cold therapy may not be effective for all migraines or in all individuals. ³

One clinical study of 100 migraine sufferers showed that 75 percent found that cold therapy provided them with at least some relief, but of course more studies are needed.

Understanding some of the theories regarding how cold therapy may make migraine sufferers feel more comfortable can enable you to discuss this potential option with your doctor.

Acute Treatment for Migraine

“Acute treatment” is when you’re trying to stop a migraine in progress (as opposed to “preventative” treatment). Acute treatments vary, as every migraine sufferer is different, but may include over-the-counter drugs or prescription ones.

Regardless of the type of drug, your doctor may recommend that acute treatment be taken right away, when symptoms first begin. In fact, the Agency for Healthcare Research and Quality’s guidelines for primary care of headaches advises that patients take medication early in a migraine attack to improve effectiveness. 2

Be sure to work with your doctor to find the right treatment for your migraines.

How Might Cold Therapy Work on Migraines?

Dr. Keri Peterson, an internist in New York City, says: “Ice helps for multiple reasons — it could be either a vascular contribution, a neurologic contribution, or endocrine.”

On the vascular system (also known as your circulatory system): It is thought that cold constricts the blood vessels (a process known as vasoconstriction), possibly creating decreased downstream blood flow and lessening the pain you may feed. A cold pack may also reduce edema (swelling).

The potential neurologic effects of cold therapy on migraine may be rooted in the fact that the cold inhibits your ability to feel the pain, a process called analgesia. Dr. Peterson elaborates: “In regards to the neurologic system, ice may slow nerve conduction, so you sense pain less readily, because the nerves are more sluggish.”

As for the endocrine system, it is thought that cold may decrease metabolic and enzymatic activity, which reduces local tissue demand for oxygen.

Lastly, it’s important to note that cold therapy could also have a placebo effect on a patient’s ability to subjectively describe their pain.

Deciding if Ice Packs and Cold Therapy Might Work For You

Migraine sufferers often instinctively self-administer supplemental pain-relief strategies, which may or may not be effective. As always, your physician is the best source for advice on treating your migraines — and what works for some sufferers may not work for you. Talk to your doctor about additional ways to ease migraine attacks and about coping with your migraines.