Cold therapy vs. heat therapy when treating headaches and migraines

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Cold therapy vs. heat therapy when treating headaches and migraines

Headaches are a problem that most people deal with from time to time, but those who experience chronic headaches or migraines know how frustrating and debilitating they can be.

Prescription medications and over-the-counter drugs can help, but it’s bothersome to take a pill every time your head hurts. The good news is there are several natural approaches you can try to manage the pain and discomfort of a pounding headache.

Cold therapy for headaches and migraines

Using ice to relieve headaches and migraines is a common home remedy, having been used for as long as 150 years. 

“Ice is often the ‘go-to’ to treat pain and inflammation, so it makes logical sense for it to be applied when your head hurts,” explains Dr. Tania Elliott, chief medical officer at EHE. But exactly what are the effects of ice on headaches or migraines?

According to Dr. Elliott, cold temperature causes blood vessels to constrict. The constriction of blood vessels helps reduce the neurotransmission of pain to the brain. Instead of registering pain, it only registers the cold feeling. In a way, cold temperature can act as a local anaesthetic that helps relieve the pain. 

A 2013 study published in the Hawai’i Journal of Medicine and Public Health found that applying a frozen neck wrap at the onset of a migraine significantly reduced pain in participants suffering from migraine headaches. The researchers believe that the cooling pack cools the blood flowing to the carotid artery in the neck. This helps to reduce the inflammation in the brain, which then helps reduce the pain felt from migraines.

What’s the best way to use an ice pack to treat a headache or a migraine?

There are a variety of ways to use this home-remedy treatment. Before anything else, ask your doctor before trying any of these strategies or if you have questions and concerns about treating your headache at home.

According to Dr. Elliott, the best way to use cold therapy for a headache or a migraine is to apply the ice pack for 15 to 20 minutes at a time. How you apply the ice pack also makes a difference in how fast you can experience relief. The 2013 study specifically recommends applying the ice in the form of a neck wrap, which can help reduce the pain and discomfort from headaches and migraines.

Dr. Alex Tauberg, a certified sports chiropractor in Pittsburgh, recommends putting the ice either over the pain or at the base of your skull. Keep the ice on for 20 minutes and then take it off for an hour. You can alternate the ice on and off until the pain subsides. Tauberg says when you put the ice pack on, you should experience four different feelings in this particular order:

  • Cold
  • Burning
  • Aching
  • Numbness

You should remove the ice once you experience numbness in the area being iced. Make sure to not put the ice pack on too long or it can damage your skin. If the burning is too intense, remove the ice. Some skin is more sensitive to cold.

Heat therapy for headaches and migraines

Heat therapy involves applying something warm to a body part to ease pain. While heat can be a trigger for some people with migraines, others find that heat therapy can be soothing when they have an attack. What works for one person may not work for another, and the treatment approach is often very unique to the individual.

Heat therapy has not been scientifically proven to relieve migraine attacks, but it has shown to be a benefit to people with tension headaches. People with migraines can also get tension headaches, and heat can be helpful in easing this pain.

How does heat help pain?

Heat stimulates nerve endings called thermoreceptors, which may block the pain signals from that area to the brain. Heat therapy also increases blood flow to the area and relaxes muscles. The increased blood flow is believed to help with pain because it increases oxygen, proteins and other nutrients to the area.

Types of heat therapy

Heat therapy may be used via dry or moist heat. Dry heat involves using a heating pad or visiting a sauna. Moist heat includes hot baths, steamed towels or moist heat packs. Moist heat warms the tissues of the body more quickly because water transfers heat faster than air.

Heat therapy is most commonly used for conditions such as arthritis, achy joints and sore muscles.

Which one to choose: Hot or cold? 

There is nothing wrong with alternating between the two treatments. Sometimes heat therapy is used in conjunction with cold therapy. Patients can apply something heated for a time and then switch to a cold compress or ice pack. These therapies are non-invasive, so they’re safe when done in moderation. For some patients, combining both therapies eases tension and aches. You may try alternating a heating pad with an ice pack or take a cool shower and then soak in a warm bath. 

Got a question, or anything I can help with? My name is Steve Stretton, and I’m the owner and manager at You can drop me a line here.  Good luck!

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