When a migraine strikes, one of the first questions many people ask is: Should I reach for ice or heat? While both cold and heat therapy can offer pain relief, using them the wrong way—or at the wrong time—might make your symptoms worse. In a recent episode of the Headache Doctor Podcast, Dr. Taves breaks down the benefits and limitations of each, along with tips to help you use them wisely for real relief.
Cold Therapy: What It Does and When to Use It
Cold therapy—whether it’s an ice pack, a gel wrap, or a cold plunge—works through vasoconstriction, meaning it narrows blood vessels to reduce inflammation and pain. It also interrupts pain signals and provides gentle pressure when applied directly to areas like the neck or head. This approach is especially helpful during an acute migraine attack or after any physical therapy or bodywork session when inflammation might be present.
Research supports this: localized cold therapy has been shown to offer short-term relief from migraine symptoms, with some studies reporting up to 80% of participants experiencing improvement.
Even full-body cold exposure, like cryotherapy or cold plunges, can offer broader benefits including improved cardiovascular health, better circulation, and reduced systemic inflammation. Just be cautious not to overdo it—excessive cold can cause issues like difficulty warming up or hypothermia-like responses.
Key Tips for Cold Therapy:
-
Use cold compresses during acute migraine attacks or after physical therapy.
-
Wrap an ice pack around the neck for targeted relief.
-
Try cold exposure in short, controlled doses—especially if attempting full-body cold plunges.
Heat Therapy: Relaxation, Not Relief for Inflammation
While cold is your go-to for calming inflammation, heat therapy increases blood flow and helps relax tight muscles. It’s often effective for tension-type headaches or general muscle stiffness—especially at the end of the day.
However, using heat during an active migraine or after treatment can worsen inflammation. “Heat exposure like a hot tub can be sort of increasing the inflammatory response that’s already there,” Dr. Taves explains, so timing is important.
Heat can activate the parasympathetic nervous system (your “rest and digest” mode), making it helpful for stress relief. But it’s also associated with being sedentary—lying down with a heat pack may feel nice but doesn’t promote the kind of movement and mobility your body likely needs.
Key Tips for Heat Therapy:
-
Use heat for chronic muscle tension or stiffness, especially outside of acute episodes.
-
Avoid heat right after physical activity or when inflammation is present.
-
Stay mindful about movement—don’t rely solely on laying down with a heating pad for relief.
Don’t Overthink It
Both ice and heat can play a role in headache and migraine care, but neither is a silver bullet. As Dr. Taves emphasizes, “you know yourself, you know your body.” Use what feels best and pay attention to when and how you apply it.
And if you’re wondering whether to invest in a $4,000 cold plunge tub, you don’t have to go that far. Start small. Even a cold shower or localized ice pack can make a meaningful difference when used at the right time.
In summary:
-
Use ice for acute pain and inflammation.
-
Use heat for chronic tension and stress-related symptoms.
-
Avoid both immediately after treatment unless specifically recommended.
-
Most importantly—keep moving. Heat or ice shouldn’t be a substitute for staying active and building your body’s resilience.
Looking for more guidance on long-term migraine relief without relying on medication? Subscribe to The Headache Doctor Podcast or visit www.noveraheadachecenter.com to learn how physical therapy can address the root cause of your headaches.
