Heat and cold are inexpensive DIY treatments you can use to reduce migraine pain. They are convenient and easy to use, plus heat and cold treatment pair well with other natural remedies or acute medications without causing an adverse reaction.

Cryotherapy is the technical term for cold therapy. Thermotherapy is the term used for heat. Both heat and cold cause changes in your blood vessels that can relieve migraine pain, but how do you know which to use?

The Effects of Heat and Cold

Heat causes blood vessels to dilate or become larger, which is a migraine trigger for many. So far, no clinical research studies show heat as a beneficial pain reducer in migraine. It can, however, help tense muscles relax. Tense muscles can also trigger migraines. 

Cold causes blood vessels to contract or become narrower. As the blood flow slows, inflammation may decrease. Your metabolic activity slows, too. Cold can reduce or eliminate nerve conduction, inhibiting pain signal transmission.

The short answer about which is better for migraine pain is: it depends. Warm compresses can relieve pain, while cold ones reduce inflammation.

Since cold therapy tends to be more beneficial, let’s talk about that first.

The History of Cold Therapy

Cold therapy has broad scientific support and has been used for over 150 years (that we know of). The first documented use occurred in 1849. 

According to a 2013 Hawai'i Journal of Medicine article, “cold therapy has long been the number one self-care treatment employed for migraine without aura and the second most common for migraine with aura.”

In a 2006 Evidence-Based Complementary and Alternative Medicine study, migraine patients who wore cold gel caps for two migraine attacks reported pain relief along with other benefits.

• About 50% reported increased comfort after wearing the caps for 25 minutes
• Around 8% to 11% reported complete relief
• 40% to 50% required pain medication because cold alone didn’t provide enough relief
• 77% of those who responded well during the first trial also experienced relief in the second

Unfortunately, 60% of those reporting no relief with cold therapy during the first trial had none in the second, suggesting cold therapy is only helpful for some migraine patients.

Types of Cold Therapy

Gel caps are an easy way to get cold therapy. Gel caps that cover the head are placed in the refrigerator or freezer and then placed on the head. You can make an adjustable neck wrap to hold ice packs against your carotid arteries running up the sides of your neck. Some patients have had success with nasal cooling.

Here are some DIY cold packs:

• Combine 2 cups water with 1 cup of 70% isopropyl (rubbing) alcohol. Pour into a quart or gallon-sized zip-top bag and remove all air before sealing. Place it inside another bag to protect against leakage and freeze for at least one hour. Wrap it in a towel before placing it on your skin to avoid frostbite.
• Place liquid dish soap in a zip-top freezer bag and remove all the air. Place inside another bag to avoid leakage and freeze for one hour. Wrap in a towel before placing it on your skin. You can refreeze it as needed.
• Frozen bags of peas, a refillable ice bag, and a cold canned beverage from the refrigerator also work well.

Whether you decide to buy an ice pack or make your own, try cold therapy during your next migraine attack to see if it helps reduce pain.

Heat Therapy Options

You can use a couple of different methods of delivering heat to your body. One is a microwavable rice-filled pack.

Simply place uncooked rice in a sock and tie or sew the end closed. Heat it in the microwave for 90 to 120 seconds, testing to ensure it doesn’t become too hot. Place it on your sore neck or back muscles for 15 to 20 minutes at a time.

A hot towel can serve the same purpose. Wet a towel or dishcloth and place it in a microwave-safe zip closure bag, leaving the zipper open. Microwave for two minutes — CAUTION: it will be hot. 

Remove the bagged towel from the microwave and wrap it in another towel, placing it on the sore spots for 15 to 20 minutes. 

Hot towels are an excellent solution for migraines and sore muscles when you travel, but you can always do it old-school with a hot water bottle. 

How to Use Cold and Heat Therapy for Your Migraine

Experiment with heat and cold to determine which works best for you. When using cold therapy, don't leave the pack on for more than 20 minutes to reduce the risk of frostbite. If you're using single-use instant cold packs, don't try to refreeze them as it is unsafe and chemically impossible. 

Apply a cold or warm moist cloth to your temples, forehead, neck, or base of the head (nape of the neck) to quickly see if the therapy helps. Alternatively, you can use ice packs or a heating pad. If heat works, try a warm shower or bath.

For heat and cold therapy, ensure the temperature isn't too extreme, and keep a towel between your skin and the cold or heat source. Keep an eye out for burns, numbness, blistering, or redness that signals potential burn or frostbite damage.

Never apply cold or heat to an open wound or irritated skin, and don't apply it for more than 15 to 20 minutes at a time.

Create a chart or take notes to find a pattern of what works best for you.

When considering heat therapy, check with your doctor first if you have:

• Heat disease
• Circulatory problems
• Diabetes 
• Skin conditions 
• Open wounds
• Bleeding disorders
• Deceased sensation in the skin

If you experience severe numbness after heat or cold therapy, call your doctor.

In Summary

So, is heat or cold better for migraine relief? It really depends on the person. Many patients find cold or heat therapy beneficial for reducing migraine pain, and some find relief from both. Cold seems to be better at pain relief, while warmth relaxes tight muscles that could be causing your migraine. 

You can use several everyday household products to make your own heat and cold packs. Avoid extreme temperatures to avoid burns and frostbite, and keep notes to help determine what works best. 

If you have questions, contact the Migraine Relief Center.