What’s Your Secret: Cold or Hot Therapy?

By Holly Harding

1 min read

Many migraineurs are drawn to extreme temperature remedies for relief of pain. A heating pad or a cold compress can make all the difference when we are seeking comfort. In this video, we discuss a few options on the market for ice and cold relief.

Please join the conversation and share your secrets for using cold or hot therapy in the comment section below. We are here to learn from one another so don’t keep your strategies to yourself!

If you have questions you’d like to pose to the Migraine.com community for the What’s Your Secret Video Series, please add them to the comment section below, or submit your question on the What’s Your Secret: Submit Your Questions! page. We have a wondrous resourceful community with a wealth of information and support just waiting to help you out.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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ronan Member
For low-grade pain, I use Tiger Balm. It turns cold and is soothing. At home, I microwave a beanbag for about 5 minutes. The combination of heat and the pressure of the beanbag on my neck and shoulders seems to help. I haven't found anything I can take on the go yet for heat purposes. I'd be interested to know what others do.
1. Kyky Knight Moderator
 Hi Ronan, Thanks for sharing! I tend to use different therapies on different days, but mostly gravitate towards warm temperatures as I find them to help relax tension. Sometimes I massage my temples under a warm shower if I am at home and can rally the energy to shower. I haven't found anything for on the go that works well for me quite yet, thanks for the tip!
2. Holly Harding Moderator & Contributor
 Hey <inline-mention user-id="3864404" username="ronan"/> - Good to hear from you! I don't know if you ever follow our facebook page, but when we released this article there earlier this week, several people listed on-the-go hot therapies- I believe one of them was called Capzasin (seems like it's a cream of some sort). <a href='https://www.facebook.com/photo.php?fbid=10215385728866843&set=p.10215385728866843&type=3&theater' target='_blank' rel='noopener noreferrer ugc'>https://www.facebook.com/photo.php?fbid=10215385728866843&set=p.10215385728866843&type=3&theater</a> You might want to check out the whole comment section that followed that article to get all the ideas. Hope that helps. Warmly, Holly B. (migraine.com team).
laney84 Member
I could not survive without my cold masks and cold Magic Bags (I store them in the freezer for when I have a migraine come on suddenly). I especially love the Magic Bags as they have some weight to them and the pressure on my head combined with the cold really helps - and it blocks light when I have it across my eyes 😀. I find heat only helpful for me at the beginning of a migraine when the pain is less - I try to take a hot shower or sometimes I will microwave my Magic bag so it is hot/warm and put it across my neck. Magic Bag is a Canadian product but I'm sure there is something similar available elsewhere. Hope this helps someone else dealing with the pain!
1. Holly Harding Moderator & Contributor
 Hi Laney84- I'm so psyched to learn of something new! Magic Bags, huh? I'll look these up right away and hope they are available in the US. Are they soft or hard like ice cubes? For me, I've experienced a number of these solutions are hard as rocks and not at all what i want to put against my head, or lay against on my neck during a migraine. Thanks so much for offering your insights/solution. Warmly (or in this case, cooly), Holly B. (migraine.com team).
cyrynda1 Member
At home I literally pack my head and neck in ice. I wrap my head in my Migraine Hat (available on Amazon or at <a href='https://www.migrainehat.com' target='_blank' rel='noopener noreferrer ugc'>www.migrainehat.com</a>), and pile ice packs around all the spaces the Hat doesn't cover. If I'm going anywhere and I'm going to be out for more than half a day I actually carry a small cooler with my Migraine Hat and its ice packs with me. I wouldn't be caught without it!
1. Holly Harding Moderator & Contributor
 cyrynda1- YAY - I'm SO glad that someone with migraine hat experience has written in! I've really wanted to ask and learn about this before buying one. Is it soft or hard ice? Like is the hat squishy and soft or hard, like a bunch of ice cubes?? Does it go down the back of your neck at all? Would be grateful for any more information you'd be willing to offer! Thanks!! Warmly, Holly B. (migraine.com team).
pwrnapper Member
As a 14 year Chronic Cluster Headache sufferer I've learned how to reduce or abort not only the number but intensity of my disabling attacks using hot and cold. Mine CH starts in the right side of my neck, muscles go into spasm pressing on bone spurs near the nerves that connect to my Trigeminal Nerve cluster. Starts with a small "knot" type spasm at first, right below my right ear, and then moves across and up the neck toward the spine and then WHAM, all HELL breaks loose, full brown CH. If I can catch this process early a hot neck pillow (<a href='https://shopbodysense.com/collections/all-1/products/neckease' target='_blank' rel='noopener noreferrer ugc'>https://shopbodysense.com/collections/all-1/products/neckease</a>), which is the best one on the market my opinion, that I warm in the microwave at home and work does the trick to reduce the muscle spasm. However once the actual CH starts the hot pillow increases the pain and discomfort. I then switch to a icy cold neck pillow, that I keep in the freezer both at home and work, while lying face down, head slightly bent forward, directly in the tense spots on my neck and bending it across my face, jaw and temple. The amount of time needed for either hot or cold depends on the level of spasm and pain I experience at the moment. When I am away from home and don't have my pillows available I use one of those chemical cold packs (Dynarex Instant Cold Pack) purchased through Amazon. It works because of a chemical reaction, squeeze it and break the chemical packages inside and it turns cold almost instantly and lasts about 15-20 minutes. There are many types of these on the market but most are terrible and just don't work. My PM doctor gave me one of these years ago and because it worked so much better I ordered a supply for myself. The combination of either hot or cold neck pillows or this Cold Pack have been a real lifesaver throughout the years. If I can stop the CH early before a full attack happens has really helped me cope with these miserable headaches. Hope these products help you too.
1. Holly Harding Moderator & Contributor
 Hi <inline-mention user-id="3772614" username="pwrnapper"/> - Thank you so much for offering your solutions to migraine (specifically chronic cluster migraine) using hot/cold therapy along with the links to that which you have found effective. You are so right that the timing is absolutely key as to when to employ which therapy. One of my favorite fellow migraineurs swears by using a heating pad on the base of her spine at the same time as using an ice pack on the base of her skull. Something about the combination of the two extremes in the two different locations works for her. I'm grateful that we are all sharing these different ideas in the hopes that others will find relief from the solutions offered here. Very warmly, Holly B. (migraine.com team).
janeth Member
For years I used a rice pack (a kneesock stuffed with a pound of rice and microwaved). I still do, but since I'm now post-menopausal, at times cold feels better than heat, especially in the warm months. I've had to throw off heat packs because of hot flashes. OTOH, if my body feels cold, I don't want to start with ice.
1. Holly Harding Moderator & Contributor
 Hi <inline-mention user-id="3871386" username="janeth"/> - Thanks so much for sharing what has worked for you in relation to hot/cold therapy. The rice kneesock is a nice idea and sounds like it could be easily homemade. Our bodies, and what they need/how they respond certainly does change over time and with hormonal shifts. I can imagine during a hot flash, the last thing one would want is more heat! Again, thanks for sharing and stay in touch! Warmly, Holly B. (migraine.com team).
yhf22y Member
I've found the IceKap, a woman in Canada created it. I keep the hat in the fridge and it is than not hard as rocks and it stays cool for 30-45 minutes. I then usually put it in the freezer for an hour or so and put it on when I go to sleep. That is what I like about the icekap, it is easy to sleep in. And it is slightly adjustable, so I can put more pressure around my head on days I want that or it is looser on those days I can't hardly have any pressure. It has 4 ice packs in it, one on top of your head and one that goes on your neck and then the sides. And it has a ponytail hole so you can get your hair out of your way. https://www.icekap.ca/ or amazon has it also. I have the original icekap but have been thinking of getting the updated version.
1. Holly Harding Moderator & Contributor
 <inline-mention user-id="3919997" username="yhf22y"/> - I can't thank you enough for this in-depth description of the icekap! This is the level of insight I've been seeking. I can't quite parse apart the difference between the icekap and the migraine hat. Something that goes down onto the neck is of utmost importance to me and something that is soft is also key. It sounds like it has the capacity to get hard as rocks if it is kept in the freezer too long, though? I wish these things were made of gel packs that never get rock hard. I will continue to do some more research but your insights were incredibly helpful. Thank you for taking the time to share your experiences with the rest of us! Warmly, Holly B. (migraine.com team).
casper6 Member
Heat works best for me. I will sleep with a heating pad on my head, if I have a bad headache. Then when I wake up during the night I shut if off, when it's gone. I also have bad neck issues, so I have another type of heating pad that will curve around my neck, but shuts off after about 30 mins. I also use bags I heat up in microwave and wrap around my neck and go on with my work at home. I even have some small gel packs that will get hot and put them inside my baseball hat to get some relief. I have used capazin, and other like it for heat at my temples and back of neck. It does help.
1. Holly Harding Moderator & Contributor
 <inline-mention user-id="3742762" username="casper6"/> - This is fascinating and thank you for providing your insights and information as to what helps you in relation to using heat for Migraine. I am most interested in the way that for some it is heat all the way and for others it is cold. It certainly makes me wonder why this if the case. It would be interesting to get the insight of a migraine specialist on this issue. You have certainly been resourceful in creating many different ways to effectively apply heat to your neck and head. Thanks again for sharing them with the community. Warmly, Holly B. (migraine.com team).
vsurdel Member
I've found that if I can stand without vomiting, a really hot shower with a massaging showerhead helps relax the tension in my head, neck and back muscles. That relieves one part of the pain. I considered a Jacuzzi for neck massage, but couldn't find one that was for less than six people. The shower helps even better cause I can do my scalp without drowning.
1. Holly Harding Moderator & Contributor
 <inline-mention user-id="3743121" username="vsurdel"/> - yes- please, don't drown! The massaging shower head sounds like a much safer alternative and a great way to get those muscles to unwind. Medical supply stores sell shower-safe seats/stools, in case the standing up thing was exacerbating the nausea/vomiting side effect. Thanks for sharing what works for you- that's a new idea that might work well for others as well! Warmly, Holly B. (migraine.com team).
carolelaine Member
An ice cap oh my head and an ice ball at the base of my skull. the ice ball is made from a mold (they are used for "on the rocks" drinks) is my go to. I also use heat on my neck and shoulders. It's not unusual to find me with my head wrapped in ice and a heating pack on my shoulders at the same time. My favorite thing to do, is to fill my antique claw foot bath tub with water as hot as I can stand and rest my neck and the base of my head on the cool, curved rim of the tub. unfortunately, I can't live in the bath.
1. Holly Harding Moderator & Contributor
 <inline-mention user-id="3694679" username="carolelaine"/> - Thanks so much for sharing your unique approach. I must admit, it sounds quite appealing. One of my migraine friends swears by the combination of a heating pad on the base of her spine and an ice pack on the base of her skull. I like the sound of the full immersion in the hot bath- with the neck/head having the ice experience. Nice! Thanks again! Great to learn from one another! Warmly, Holly B. (migraine.com team).
griff Member
F
griff Member
I have a lrg rectangular ice pak......I can wrap my head from my eyebrows around sides and down to neck......drop my head into soft pillow that holds pak against my head.......though my attacks are more left sided this whole head ice pak works for the worst of the worst.
1. Holly Harding Moderator & Contributor
 Hi there, <inline-mention user-id="3686536" username="griff"/> - Sounds like a wonderful resource-- do you remember where you found such a large one? I'd like to get a bigger one than the ones I have (which are probably 10 inches in length by 5 inches tall). Thanks in advance for any tips you can offer. Warmly, Holly B. (migraine.com team).
elfie Member
I like a bit of both.I always keep a couple of cheap packs of frozen peas in freezer,(peas are a good size and mould well around your head). I don't find anything else is cold enough. When one starts to melt too much I refreeze and replace with the other. It can feel a bit unleasant if it starts dripping down your face but to be honest I never care because the relief it provides is worth it. I usually get about 1 to 1 1/2 hours before it defrosts too much depending on size of bag.I often use this with microwave heated bean bag round neck. Then get under the duvet find a comfortable position and leave the window wide open if you can for fresh air even in winter.
1. Holly Harding Moderator & Contributor
 Hi <inline-mention user-id="3729137" username="elfie"/> - Thanks so much for sharing your unique approach that combines heat and cold. I'm not sure if you watched the video above, but in it, It shows these little mini-pillow cases made out of fabric that I use to hold my ice packs so they don't get drippy. I found them at my chiropractor, but if you're handy, you could probably make them yourself- or you could just wrap the peas in a fabric napkin. Of course, then you lessen the nice freezing cold temperature of said peas! Just a thought. I like your ideas very much- I use the duvet + open window approach regularly. So glad you shared! Thanks again! Warmly, Holly B. (migraine.com team).
gainpa Member
My go to emergency kit at work: 1) sunglasses 2) for heat: ceramic mug filled with microwaved water. Wrapped napkin around it and held it in back of my ear along my neck, the inside of my cheek against my nose at an angle. 3) For cold: can of caffeinated soda fresh from the vending machine. Same pattern: back of the ear, front of the ear, along the inside of the cheekbone along my nose. As the can lost it's chill, I would pop the tab and drink the soda with whatever pain pill I was using at the time. At home: Large round, glass jars (like Gulden's mustard) with an indented base were perfect to hold against my cheek under the eye with the indented base against my cheek bone.
1. Holly Harding Moderator & Contributor
 <inline-mention user-id="3796059" username="gainpa"/> - i LOVE these DIY solutions for hot and cold therapies. Your solutions can be found in most office complexes- or out and about so can be used by any of us in a pinch should we be caught off guard by pain and in need of some relief. You are wonderful to share these great ideas with the rest of us! Thank you so much! Warmly, Holly B. (migraine.com team).
mdavis87 Member
My go to is a heated eye mask (<a href='https://www.amazon.com/Relieve-Therapeutic-Treatment-Fatigue-Circulation/dp/B07WJKFPHW' target='_blank' rel='noopener noreferrer ugc'>https://www.amazon.com/Relieve-Therapeutic-Treatment-Fatigue-Circulation/dp/B07WJKFPHW</a>) Paired with a weighted sleep mask that I can wrap tight or loose for the right amount of pressure <a href='https://www.amazon.com/nodpod-Gray-28-Long/dp/B07B43HVKY' target='_blank' rel='noopener noreferrer ugc'>https://www.amazon.com/nodpod-Gray-28-Long/dp/B07B43HVKY</a> Then to top it all off I use a neck massager to knead out any pain in my neck <a href='https://www.amazon.com/Massager-Massage-Pillow-Heating-Function/dp/B07P85WHBL' target='_blank' rel='noopener noreferrer ugc'>https://www.amazon.com/Massager-Massage-Pillow-Heating-Function/dp/B07P85WHBL</a>.
1. Holly Harding Moderator & Contributor
 Thank you so much for sharing what works for you, MDavis87!- These products are all new to me so I'm grateful you passed them along. The neck massager looks particularly appealing- and super cool that it has a heating function. Again, thanks for your recommendations. Please stay in touch!
CommunityMember358 Member
I have a few very soft linen kitchen towels. I soak one in hot water, wring it out and put against the painful area - or worst to least, reheating when needed. But those are cluster and cervicogenic headaches, when I think I'm dying. Migraines, I can find a position of constant pain and not move till the migraine ends - generally about 12 start to end. But I grew up with migraines, and had to act "normal", so I have ways to minimize. I dislike cold.
1. Cheryl Picerno Moderator
 <inline-mention username="CommunityMember358" user-id="3764247"/> Hot/cold therapy or a combination of both is something I have seen frequently with our community members. I have always favored heat therapy, either dry or moist. I have always found it to be helpful and comforting. My husband prefers cold therapy on his head for migraine cycles but also uses heat therapy with it for pain in other areas of his body. Living with migraine is hard on us. In my opinion, trying to remain"normal" during our attack cycles or hiding our disease wears us down even further. It's ok for us to accept that we have a neurological disorder, an invisible disease. We can't see many other diseases like bowel disorders, endometriosis, or blood diseases, but they are fully present in many lives. Migraine disease is getting more exposure, but it is still under-researched and underfunded compared to other disorders. Thank you for sharing your experience with us. Warmly, Cheryl <a href='https://migraine.com' target='_blank'>migraine.com</a> team
2. Holly Harding Moderator & Contributor
 <inline-mention username="CommunityMember358" user-id="3764247"/> Thank you so much for sharing your heat solution. This does sound comforting and useful. What an excruciating 12-hour window of time waiting out such a high level of pain and related neurological symptoms. Besides the warm cloth and being very still, what other strategies have you found to help you get through these attacks? I'm sure you have a lot of wisdom from which we could learn. So grateful you are with us. Warmly- Holly <a href='https://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team.
CommunityMember1124dc Member
I get cluster headaches. If I'm at home, as soon as a feel a headache coming on I put a cold compress on the back, left side of my neck. (a cold pack from the freezer for medical use which is flexible, not a cold pack for keeping a cooler cold) And then I meditate for 15 minutes with the compress. If I catch it soon enough, it stops it out. If I'm out and get a headache I give myself an injection of 4 mg of Sumatriptan (Imatrix) with an autoinjector. Stops the headache in 6 minutes. Works great but not cheap. With insurance I'm still paying $13 per shot. Retail is closer to $60
1. Cody Leach Community Admin
 So glad to hear that you have a protocol that works for you, <inline-mention username="CommunityMember1124dc" user-id="8642909"/>. I would love to have my headaches eliminated in 6 minutes! Perhaps I will check in with my neurologist and see what they think about an injectable Imatrix. I have tried the pill form, and it works sometimes. Seems to lose its effectiveness over time for me. Appreciate you sharing 😁. - Cody (Team Member)
CommunityMemberc7cdc0 Member
I am always too cold. But when I get a migraine I feel like all the warmth is just being sucked out of me, yet I cannot stand any extreme changes on/near my head. So I will get a heating pad and try to warm my core. Maybe in a day or so I can use some heat on my neck. 
1. Cody Leach Community Admin
 That is a very common experience among the community, <inline-mention username="CommunityMemberc7cdc0" user-id="8320983"/> . Check out this article here, which talks more about temperature regulation with migraine: <a href='https://migraine.com/living-migraine/body-temperature-regulation' target='_blank'>https://migraine.com/living-migraine/body-temperature-regulation</a>. Hope that it helps provide some clarity, and remind you that you're not alone with all of this! - Cody (Team Member)
2. Holly Harding Moderator & Contributor
 <inline-mention username="CommunityMemberc7cdc0" user-id="8320983"/> - I'm also always cold and it seems to be getting worse as I get older? My feet stay freezing for hours after a walk outside. I've gotten to the point that I need a heating pad to warm them up. I haven't paid attention to whether or not I feel colder with a migraine- that's a fascinating question. Of course, migraine is a neurological condition that can impact our bodies in so many ways. Thanks for sharing. Warmly- Holly <a href='https://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team
Elaine S. Member
I use a Comfitech hat. Lots of similar things on Amazon. It is a soft gel like fabric that you freeze. It covers your head, down over your ears and eyes. Pretty snug on your head, so it might bother some people. (Comes in medium or large, though. I have medium) Very cold out of the freezer — I have to let it warm up a bit. And I just saw that they have a gel neck wrap that looks like it goes high up your neck and it secures around the neck. I’ve been using a loose one, but the fitted one looks good. Cold is my last hope when I’m miserable and low on meds.
1. Holly Harding Moderator & Contributor
 <inline-mention username="Elaine S." user-id="3729759"/> - Thank you so much for chiming in to share your solution to cold therapy. I'd not heard of that one before- but yes you are right there are so many takes on the same thing. I like hearing that they have something to address the neck- that is what I would need. Do you think you'll get it? And yes- it's amazing how cold compresses can calm pain- sometimes just as well as the meds we take. Thanks again for sharing this resource. Warmly (or cooly!)- Holly <a href='https://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team
Elaine S. Member
Yes, I just ordered the neck wrap and a second hat. Looking forward to having a backup in the freezer!
1. Holly Harding Moderator & Contributor
 <inline-mention username="Elaine S." user-id="3729759"/> - Love having a backup, too. I have three different soft gel packs that I rotate as they warm up fast. I'd appreciate your telling us your thoughts on the neck wrap you ordered after you try it out! Thanks so much for being a part of our community. Warmly- Holly <a href='https://-migraine.com' target='_blank' rel='noopener noreferrer ugc'>-migraine.com</a> team
Rebecca C Moderator
Great tools to utilize, <inline-mention username="Elaine S." user-id="3729759"/> - Having a neck wrap and a backup hat in the freezer can be a smart approach for quick relief when a migraine strikes. Thanks for sharing. Rebecca (community moderator)
FudgeKitty01 Member
I make my own flexible cold packs from heavy duty freezer bags by Qinline (Amazon asin: B07VD4794V). I put 1/2 c. water & 1/4 c. rubbing alcohol in them. 3/4 c. water can be used for a more solid bag. I keep two in the freezer all the time: one for my forehead & on for the base on my skull. I have not had issues with them leaking, unlike Ziplock type freezer bags. 
1. Alene L. Brennan, RYT Moderator & Contributor
 That's incredibly resourceful of you <inline-mention username="FudgeKitty01" user-id="8645676"/>! Thanks for sharing the combination or "recipe" that works best for you. It helps give many of us ideas to perhaps try it out as well. - Alene, moderator 
2. Alene L. Brennan, RYT Moderator & Contributor
 <inline-mention username="Holly Harding" user-id="3755969"/> I previous got a letter from my doctor saying that I needed to travel with ice packs out of medical necessity. The reason was more due to my heat intolerance from MS, but I wonder if you could talk with your doctor about possibly getting a letter for travels. It might be worth a try! - Alene, moderator
bonanna Member
Hello, Holly, I was going through my emails and found this post from several months ago, but I had to share my experience. I definitely prefer ice for my migraines and only use heat when one of my symptoms is that I'm freezing cold and can't warm up. I have a great ice cap that I got from Amazon in 2021, but, unfortunately, it's no longer available. It has a fabric cover, wraps around the head with a round flap that covers the top of the head and also comes down the back of the neck. The ice pack is very firm but not rock hard and with just a little squeezing will soften to meet your preference. I highly recommend one. Amazon has lots of options. Now, I have a dyi tip for ice on the go. Reuseable sandwich bags are wonderful to quickly fill with ice wherever you are. You can easily carry them in your purse and keep in your car. They must be the soft, flexible type to be comfortable. Since I sew, I've made several terry cloth neck "scarfs" with pockets from dish towels to hold the ice filled bags. I like 3 pockets, which goes all the way around my neck, but don't always use them all. I may use only 1 or 2, but they are great to tie around your neck while you're driving, at work, home or even the grocery store. If I'm on the road and don't have enough ice in my water bottle, I simply pull up to the nearest drive-thru and order some small item (french fries, chicken nuggets, a cookie, etc) and a large cup of ice. Sometimes, I just use a bag full of crushed ice without a towel and rub my neck, temples, face and head, massaging with the ice bag. As a great preventative, I use one with 3 bags while I'm working outside in the summer to keep from getting overheated, which is a trigger for me. Great plus - no dripping!
1. Alene L. Brennan, RYT Moderator & Contributor
 <inline-mention username="bonanna" user-id="4280163"/> we're so glad that you found this email and returned to the conversation. Thank you so much for sharing your personal experiences and recommendations. That's a bummer that the Amazon pack is no longer available, but I do agree with you, they still have many options. And that's amazing that you've used your sewing talent to create a pack of your own. If you ever had the time, you could open a shop on etsy to sell them! Thanks again for sharing your personal recommendations, they're great! Alene, <a href='https://migraine.com' target='_blank'>Migraine.com</a> Team Member