If you live with migraine, you may have tried ice therapy to reduce the pain. But did you know that where you put ice packs during a migraine attack may matter?

Ice therapy may refer to practices like cold compresses or cryotherapy. Whether you use a bag of frozen peas, a gel pack from the freezer, a plastic bag filled with ice cubes and water, or an ice cap, cold therapy is an old remedy for migraine pain relief. In fact, the first doctor to document using ice and salt to treat headache did so in 1849.

More recently, doctors reviewed several studies on cold therapy for migraine symptoms. Some studies suggest cold-gel headbands, caps, intraoral cooling, cold wraps, and ice packs may help reduce migraine pain for some people. But it doesn’t help everyone, and results can vary.

How Ice Therapy May Help Migraine Pain

Doctors believe that ice packs and other forms of ice therapy may help reduce migraine pain in a few ways. It can:

• Reduce sensitivity to pain
• Slow pain signals and swelling
• Lower skin temperature and numb the area

A 2013 study found that it took ice packs on the neck about 15 minutes to start reducing migraine pain and 30 minutes to deliver maximum headache relief. The pain relief lasted for an hour after the cold was removed. In people who did not use any cold therapy, pain increased at 30 minutes and continued getting worse at one hour.

One MyMigraineTeam member said, “I sometimes use cold for my migraines. I keep two small bags of frozen peas in my freezer for this purpose. The flexibility of the peas works for me. Also, it’s not as cold or as hard as an ice pack. The hard packs hurt my head, and I can’t get them to feel comfortable.”

Another said, “A cold head really eases the migraine’s bite.”

Where Is the Best Place To Put an Ice Pack for Migraine Relief?

Where people put an ice pack for migraine relief is as diverse as migraine attacks themselves. Some people find the most pain relief when an ice pack is pressed on the forehead or back of the head, against the temples, on the jaw, at the base of the neck, or across the eyes.

That 2013 study theorized that cold therapy placed on the neck, just below the jaw, may have helped by cooling blood flowing through the carotid arteries to the brain, which could potentially reduce migraine pain. Many people with migraine also have neck pain, so ice therapy on the neck could be helpful.

It may be helpful to cool the temperature of your room, too. Overheating and sudden temperature changes can be a migraine trigger for some people, so turning down the air conditioning or pointing a fan at yourself may increase the effects of your ice packs.

Members of MyMigraineTeam wrote:

• “Ice sometimes makes the back of my head better and heat worse.”
• “I just got an ice hat, and it has gel packs all around it, and it helps. I got the large so I could pull it down to my eyebrows and the back/base of my skull.”

Tips for Using Ice Packs Safely During a Migraine

Using cold therapy directly on the skin can be uncomfortable or even damage the skin. That’s why doctors often recommend using an ice pack for up to about 15 minutes, then taking it off for a while. You should also place a thin cloth between your skin and the ice pack. Don’t fall asleep with an ice pack on your skin.

You can use ice packs several times a day if needed for relief. Many people in the MyMigraineTeam community report keeping multiple ice packs in the freezer or refrigerator to swap out as they warm up.

Comfort is key when choosing which type of ice therapy to use. Several people on MyMigraineTeam report that ice hats or ice caps are too cold, and they prefer individual ice packs or bags of frozen peas. Others value the eye cover that is built into some ice caps.

Members of MyMigraineTeam say:

• “Ice hats seem to be too cold, but regular soft ice packs on the neck work great.”
• “Eye pain is the first sign that a migraine is coming on for me. An ice hat helps, and I wear sunglasses indoors.”

When Should Ice Packs Be Avoided?

Be sure to follow your doctor’s guidance on ice-pack use. Ice packs that are too cold, or that are used for too long, put you at risk of frostbite and tissue damage.

Do not use cold therapy if you have any of the following:

• Raynaud’s syndrome — In people with Raynaud’s syndrome, cold can narrow the blood vessels and trigger abnormal, prolonged spasms. This can worsen blood flow and may lead to tissue damage.
• Cold urticaria or cold hypersensitivity — People who have allergic reactions to cold may develop symptoms in one area or throughout the body, so they should not use surface cold therapy.
• Poor circulation — Cold therapy should be avoided on areas of the body where blood flow is already reduced or impaired.
• Impaired sensation — People with reduced feeling, such as from diabetic neuropathy, may not notice when the skin is getting too cold, which raises the risk of skin injury.

If you lose feeling in your skin or your skin turns pale where you have applied the ice pack, stop using it immediately. These symptoms are the first signs of frostbite.

How Ice Therapy Fits Into a Migraine Relief Plan

Ice packs can be a helpful nondrug element in your pain relief toolbox, along with preventive and acute medicines and other supportive treatments.

However, just as with other migraine home remedies, ice packs do not work for everyone. Some find heat or an at-home nasal cooling device more soothing. One member reported:

“Sometimes ice packs make my head feel 10 times worse. It’s weird. I don’t know if it’s a different type of migraine or what, but ice makes it feel 10 times worse.”

It may take some time to find the right combination of ice therapy, medicines, and other supportive care to control your migraine pain. Talk with your healthcare provider if you find that ice therapy stops working after it previously brought relief, or if your symptoms seem to be getting worse.

Join the Conversation

On MyMigraineTeam, people share their experiences with migraine, get advice, and find support from others who understand.

Have you tried cold therapy for migraine pain? Where do you place an ice pack for the most relief? Let others know in the comments below.