Ice and Heat for Headache

Beautiful woman with a painful pounding headache

Overview

Hot and cold packs are widely used, very inexpensive, have some evidence of effectiveness and are generally very safe. They are worth a try. Which to use when? There are no hard and fast rules. Migraine suffers appear to prefer cold, while tension headaches seem to respond better to heat. Hot and cold packs are used the world over for headaches and are the number one self-treatment for migraine.

RESCU Treatment Ratings

R = Risk      E = Effectiveness      S = Self-Care

C = Cost     U = Usefulness (overall rating)

1 = Least Favorable     5 = Most Favorable

R

RISK: 5/5

Injuries can occur from burns if heat, such as through hot packs, is too hot or left on for too long. Patients with reduced sensation, such as numbness or diabetic neuropathy, should use heat and cold with care. Ice burns can also occur if the skin is cooled too much. Some conditions can be worsened with heat or cold, however generally, and especially in comparison with other treatments for pain, hot and cold packs are pretty safe.

E
S
C
U

Ice and Cold Packs for Headache Summary

There is actually little research on the effectiveness of ice or heat for headaches, though they seem to used the world over for headaches and are the number one self-treatment for migraine. For ice packs, you can use frozen corn or peas, commercial cold packs, or a small resealable bag, such as a ZiplockÒ, filled with crushed ice. Apply ice for 10-20 minutes (not longer) once an hour while you are up. Don’t fall asleep with an ice pack, and always use a thin towel between the ice pack and your skin to avoid an ice burn.

Similarly, heat packs are widely available. You can also wet a small towel, such as a dishtowel and microwave it for 20-45 seconds. Be careful not to burn yourself. Moist heat is thought to penetrate more deeply, but any source of heat, such as an electric heating pad may help. Heat should generally not be used for more than 15 to 20 minutes per hour since the tissue needs time to return to a normal temperature periodically or it can become damaged.

Sources:

Nadler SF, Steiner DJ, Erasala GN, Hengehold DA, Hinkle RT, Beth Goodale M, Abeln SB, Weingand KW, Continuous low-level heat wrap therapy provides more efficacy than Ibuprofen and acetaminophen for acute low back pain, Spine 2002 May 15;27(10):1012-7

Sprouse-Blum AS, Gabriel AK, Brown JP, Yee MH. Randomized Controlled Trial: Targeted Neck Cooling in the Treatment of the Migraine Patient. Hawai’i Journal of Medicine & Public Health. 2013;72(7):23

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