title: Randomized controlled trial: targeted neck cooling in the treatment of the migraine patient.
abstract: Cold therapy has long been the number one self-care treatment employed for migraine without aura and the second most common for migraine with aura, yet its mechanism remains elusive. In this study, a mechanism by which this time-tested therapy works is proposed (by cooling the blood passing through intracranial vessels) in an attempt to further elucidate its beneficial effects. The study is designed as a randomized, controlled, crossover clinical trial utilizing an adjustable wrap containing two freezable ice packs targeting the carotid arteries at the neck, where they come close to the skin surface. Fifty-five participants successfully completed the study. Pain at onset, as recorded on a visual analog scale, was similar between the two treatment arms. Maximum pain reduction was observed at the 30 minute time point with a 31.8% ± 15.2% decrease in pain in the treatment arm compared to a 31.5% ± 20.0% increase in pain at the same time interval in the control arm. These findings confirm the application of a frozen neck wrap at onset of migraine headache targeting the carotid arteries at the neck significantly reduced recorded pain in participants with migraine headaches (P<.001).
authors.affiliation: University of Hawai'i at Manoa, Honolulu, HI, USA. adamsprouseblum@gmail.com
authors.forename: Adam S
authors.initials: AS
authors.lastname: Sprouse-Blum
authors.forename: Alexandra K
authors.initials: AK
authors.lastname: Gabriel
authors.forename: Jon P
authors.initials: JP
authors.lastname: Brown
authors.forename: Melvin Hc
authors.initials: MH
authors.lastname: Yee
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D017679:Cryotherapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000503:physiopathology / Q000628:therapy*; D009333:Neck / Q000502:physiology; D010147:Pain Measurement; D055815:Young Adult
references.citation: Am J Sports Med. 1994 Jul-Aug;22(4):537-40
references.pmid: 7943521
references.citation: J Athl Train. 2004 Mar;39(1):88-94
references.pmid: 15085216
references.citation: Pain Med. 2001 Dec;2(4):267-79
references.pmid: 15102231
references.citation: Am J Sports Med. 1982 Sep-Oct;10(5):316-9
references.pmid: 6814272
references.citation: Int J Sports Med. 2001 Jul;22(5):379-84
references.pmid: 11510876
references.citation: Evid Based Complement Alternat Med. 2006 Dec;3(4):489-93
references.pmid: 17173113
references.citation: Arch Phys Med Rehabil. 1965 Mar;46:216-44
references.pmid: 14271050
references.citation: Arctic Med Res. 1991;50 Suppl 6:13-7
references.pmid: 1811567
references.citation: Cephalalgia. 2001 Sep;21(7):718-26
references.pmid: 11594999
references.citation: Headache. 1989 Oct;29(9):598-600
references.pmid: 2584002
references.citation: Physiotherapy. 1978 Jan;64(1):2-6
references.pmid: 628689
references.citation: Scand J Med Sci Sports. 1996 Aug;6(4):193-200
references.pmid: 8896090
references.citation: Eur J Appl Physiol Occup Physiol. 1997;76(6):538-43
references.pmid: 9404866
references.citation: J Athl Train. 2002 Apr;37(2):209-17
references.pmid: 16558673
references.citation: Int J Clin Pract. 2005 Jul;59(7):760-3
references.pmid: 15963200
references.citation: Headache. 1988 Aug;28(7):458-61
references.pmid: 3243707
references.citation: Int J Microcirc Clin Exp. 1997 Mar-Apr;17(2):55-60
references.pmid: 9253681
references.citation: Clin Sci. 1958 Feb;17(1):165-79
references.pmid: 13511729
references.citation: J Orthop Sports Phys Ther. 1999 Mar;29(3):177-80
references.pmid: 10322591
references.citation: Med Sci Sports Exerc. 2005 Jul;37(7):1093-8
references.pmid: 16015124
references.citation: Am J Sports Med. 2001 May-Jun;29(3):288-91
references.pmid: 11394596
references.citation: Aviat Space Environ Med. 1985 Jun;56(6):568-71
references.pmid: 4015569
references.citation: J Bone Joint Surg Am. 2002 Sep;84(9):1573-8
references.pmid: 12208913
references.citation: Postgrad Med. 1986 Jan;79(1):305-9
references.pmid: 3941818
references.citation: Anesthesiology. 1966 Nov-Dec;27(6):805-10
references.pmid: 5924554
references.citation: CMAJ. 2013 Mar 5;185(4):E201-11
references.pmid: 23359047
references.citation: J Oral Maxillofac Surg. 1986 Oct;44(10):790-3
references.pmid: 3463707
references.citation: J Athl Train. 1997 Jul;32(3):233-7
references.pmid: 16558455
references.citation: Science. 1965 Nov 19;150(3699):971-9
references.pmid: 5320816
references.citation: Heart Dis. 2001 Nov-Dec;3(6):357-61
references.pmid: 11975819
references.citation: J Pain Symptom Manage. 1998 Apr;15(4):235-43
references.pmid: 9601159