Do migraine hats/wraps work?

If you have migraine attacks, you’ve probably tried a lot of remedies; medications, lifestyle tweaks, even a cold compress on the head. One of the increasingly popular options is the so-called “migraine hat” or cold/wrap headgear: essentially a headband, cap or neck wrap that uses cooling (and sometimes light compression) to help ease the pain of an attack. These devices are designed to be simple, non-drug adjuncts that you can keep in the freezer and apply at the first sign of a migraine. They appeal especially to patients looking for something low-risk, drug-sparing or to use alongside their usual rescue medications.

So how do they work? The proposed mechanism is two-fold: first, the cold causes scalp and may produce superficial vessel vasoconstriction, which may reduce the neurovascular activation and dilatation associated with migraine pain. Second, the cold may have a “gate-control” effect by reducing nerve conduction speed or modulating pain signalling in the superficial trigeminal and scalp nociceptors (something we see with neuromodulation devices). one randomized crossover trial found that applying a frozen neck wrap significantly reduced pain scores compared with a non-frozen wrap.  A systematic review and meta‐analysis of six studies found that cold interventions reduced pain at 30 minutes compared with non-cold regimens (although long-term effects were less clear).

Overall, the data is modest but suggest that these wraps/hats may provide short‐term relief of an acute migraine attack. Migraine hats/wraps can be a quick, safe, and generally inexpensive option for migraine relief, but should not replace preventive treatment. They may be most useful early in the attack, put them on at the first hint of onset, not after your headache has become severe. Always be sure to consult with your provider regarding headache and migraine treatments, especially if you’re combining it with other acute therapies or have scalp/neck vascular issues.

References:

Sprouse-Blum AS, Gabriel AK, Brown JP, Yee MH. Randomized controlled trial: targeted neck cooling in the treatment of the migraine patient. Hawaii J Med Public Health. 2013 Jul

Hsu YY, Chen CJ, Wu SH, Chen KH. Cold intervention for relieving migraine symptoms: A systematic review and meta-analysis. J Clin Nurs. 2023 Jun