A Warm or Cold Compress for Headaches

Whether you suffer from occasional or chronic headaches, you have probably tried different techniques to relieve the pain. Many people use a warm or cold compress, either alone or with other treatments. Unfortunately, this time-honored practice has not been well studied. In the absence of conclusive research, most healthcare providers suggest selecting between a warm or cold compress based on what works best for you.

No Hard, Fast Rules

There are no evidence-based guidelines to aid your choice of whether to use a cold or warm compress for a headache. However, the type or cause of your headache can aid your choice of which temperature compress to try initially. If your first choice isn't helpful, there is no harm in trying a compress of the opposite temperature. Since there are many types and causes of headaches, the temperature of the compress that provides the most relief for you might change from one headache to the next.

Tension-Type Headaches

Tension-type headache is the most common headache disorder, affecting 30 to 78 percent of people over the course of their lifetime, according to the International Headache Society 14. Although the specific mechanisms that provoke tension-type headaches remain poorly understood, nervous system input from the muscles of the head, neck and upper back appears to play a role. Many people with a tension-type headache report simultaneous discomfort in some or all of these muscles 14. Heat can relax and soothe these muscles, potentially providing some relief from a tension-type headache 14. You might try a warm compress on the head or a heated neck wrap, although there is no conclusive research proving this is beneficial.

Migraine Headaches

Migraines are the second most common type of headache disorder. Approximately 18 percent of people experience migraines in their lifetime, reports the International Association for the Study of Pain 2. The biological mechanisms that lead to migraines remain incompletely understood, although current research points to altered function of the brain that makes it overly excitable. Migraine pain is typically throbbing in nature and limited research suggests that cold therapy might be helpful. A small study published in December 2006 in "Evidence-Based Complementary and Alternative Medicine" found that application of a cold gel pack during a migraine reduced the pain severity in 50 percent of the study participants 7. In a separate study published in July 2013 in the "Hawaii Journal of Medicine and Public Health," application of a cold neck wrap during a migraine led to reduced pain in 77 percent of participants who used the treatment 8.

Other Headaches

Headache is a common symptom that occurs with a wide variety of illnesses. In these situations, complete headache relief often depends on recovery from the underlying ailment. However, a warm or cool compress might provide some pain relief in the interim. If you have a headache and a fever due to the flu, for example, a cool compress may be more soothing than a warm one. However, a headache due to sinusitis may respond better to alternating warm and cool compresses, advises the American Academy of Otolaryngology -- Head and Neck Surgery 9. Depending on your situation, you might need to experiment with warm and cool compresses to see which one provides the most pain relief.

Warnings and Precautions

See your doctor if you have frequent, persistent or worsening headaches to determine the cause and best course of treatment. Most headaches do not represent a medical emergency, but there are some exceptions. Seek immediate medical care if you have a headache with any of these characteristics or accompanying danger signs: -- sudden headache that rapidly escalates to severe pain -- neck stiffness and fever -- eye pain or vision problems you've not experience with previous migraines -- unsteadiness, loss of balance or slurred speech -- excessive drowsiness, confusion or mental slowness -- weakness or paralysis affecting a specific area of the body

Reviewed and revised by: Tina M. St. John, M.D.