Cold therapy—like using ice caps or chilled wraps—has gained popularity among migraine sufferers looking for quick, drug-free relief. But does it actually work? According to a handful of clinical trials and expert opinions, cold therapy may provide short-term relief during an attack, but it’s not a cure—and it’s not equally effective for everyone.
What the Research Says
Several small studies suggest that cold therapy can reduce migraine intensity in the moment. In one such study, half of participants reported less head pain after using a cold cap for just 30 minutes. Another report found that over 70% of individuals who used a chilled neck wrap during a migraine attack experienced symptom relief.
A 2022 systematic review of six studies confirmed that cold therapy can ease migraine pain while it's happening—especially when used alongside other treatments. However, the review also emphasized that medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), ergotamine, and triptans are often more effective at providing lasting relief.
Importantly, as Dr. Zubair Najib points out, we still don’t know how cold therapy compares to other non-pharmaceutical treatments like biofeedback or cognitive behavioral therapy. The research simply hasn’t been done yet.
Cold Therapy Targets Pain—But Not Every Symptom
Most studies focus on how cold therapy affects head pain, not the full spectrum of migraine symptoms. “For many migraine patients, pain may not even be the most bothersome symptom,” says Dr. Najib. Nausea, vertigo, brain fog, or extreme sensitivity to light and sound may be more disruptive—and cold therapy isn’t likely to help with those.
Why Cold Might Help
Doctors don’t fully understand why cold therapy works, but they have a few working theories:
- Inflammation Reduction: Cold temperatures may decrease the release of inflammatory neurochemicals in the brain that are thought to trigger migraine pain.
- Blood Vessel Constriction: Migraines often involve dilated blood vessels. Applying cold causes the vessels to constrict, potentially reducing pain signals.
- Pain Distraction: The sudden change in temperature may redirect your brain’s attention from migraine pain to the sensation of cold.
Still, Dr. Najib notes, “That’s our best understanding—but a lot of it remains unknown.”
Temporary Relief, Not a Cure
Cold therapy usually provides only short-term relief. “Typically, these therapies work for 30 minutes to an hour,” says Dr. Najib. Once you remove the ice, there’s a good chance the pain could return.
That said, cold therapy isn’t likely to make things worse—and it’s low-risk and inexpensive. You don’t need a high-tech gadget; a basic ice pack, cold wrap, or even a bag of frozen vegetables will work. Dr. Najib recommends applying it to the area where the pain is most intense, or to the neck if the pain is diffuse.
Apply for 15–20 minutes while lying down in a dark, quiet room. If you’re at work or in public, even a brief cold application might help. Just avoid using ice for more than 20 minutes per hour to prevent frostbite.
Final Takeaway
Cold therapy won’t replace medication or cure migraines, but for some people, it might offer quick and simple relief. “There’s really nothing to lose,” says Dr. Najib. If it doesn’t work, you haven’t harmed anything—and if it does, you’ve gained a new tool to help manage migraine attacks.