A person is cooling off by resting their head in an opened freezer.

Cold vs Hot Therapy for Migraine: Which One Are You?

Last updated: October 2023

You always remember the firsts: The first time you ride your bike or the first (and last) time you try bleu cheese. I remember these moments, but I can also add my first migraine to that list. However, at the time, I didn’t know that’s what it was. When I was 22 years old, I had all of my wisdom teeth taken out, and not only did my face swell to twice its normal size, but my brain felt like it was on fire. I remember my mom cradling my head in her lap while she applied heat. Now I know the heat might’ve made my head pain worse.

Has heat therapy worked for me before?

When my migraines became a predictable thing in my life, along with my love of Harrison Ford and my disdain for bleu cheese, friends told me to try heat. A heating pad had always been my go-to in the pain-soothing department anyway. I loved the way the cozy warmth made my sore muscles or achy stomach hurt less. So, I used a heating pad on low on the back of my neck or a warm towel over my eyes during a migraine. But lying there in the dark with my brain boiling, I wondered if it did anything at all besides make me sweat.

Why did I continue using heat if it wasn't working?

Like a stubborn toddler trying to put a square peg into a round hole, I continued using heat during a migraine even though it didn’t do much good. I told myself the warmth should help. It soothed other things, so it must be something I was doing wrong. I didn’t expect the warmth to be a miracle cure, but I did hope it could offer some sort of comfort. My nurse mom was the one who told me about heat - that heat helps relax muscles and increases blood flow. So, clearly, this was user error. What was I doing wrong?

When did cold therapy come into play?

Hot and cold therapies can be used to ease migraine pain,” my neurologist mentioned during our first visit. I was totally confused. Did he say "cold?" The thought of placing a cold compress on my head made me shiver. How had I never heard about this? My doctor explained cold works better than heat in some migraine patients, but it really came down to personal preference. Maybe I'd been making the wrong choice when it came to hot or cold.

Did the cold help my migraine?

I was nervous, but for my next migraine, I decided to try the power of the cold. I had a gel pack cooling in the freezer and a washcloth ready to run under the cold water. The gel pack was my first choice, but it was way too frosty and made my pain worse. I moved to the cool washcloth. I immediately felt my pain turn down a notch and my brain softened to a simmer instead of a high boil. To this day, cold therapy is still a "cool" tool that I keep in my bag o' tricks to help me through a migraine - even though I didn't choose it first.

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