Device 1: Cooling caps

Remedy 1: Cooling Caps

What is it?

Cooling caps are portable, sealed containers or pouches filled with a substance that can be chilled or frozen to provide cold therapy. They're used to reduce pain, inflammation, and swelling from injuries or medical conditions.

Regimen:

• What - Frozen pouches or wraps

• When - From the time that pain starts

• Details - Effective from 10-30 mins of application

How does it work?

The 3 main systems targeted by Cooling caps are:

1. Vascular: Cold causes vasoconstriction, which leads to narrowing of blood vessels. This leads to reduced blood flow, resulting in decreased pain.

2. Neurologic: Cooling caps help reduce pain by slowing down how fast nerves send signals. It affects the sensory fibers (like pain or temperature) before it affects the motor fibers. Among these, the smallest nerves with insulation (called myelin) are slowed down first, followed by larger ones, and the uninsulated (unmyelinated) nerves are affected last.

3. Endocrine: Cooling caps decrease metabolic activity, resulting in less oxygen demand in cooled tissues.¹

What is the efficacy?

Method: Studies were done to evaluate localized cold therapy for migraine relief. The 2013 randomized controlled crossover trial (n=55) used a neoprene neck wrap with frozen ice packs over the carotid arteries, comparing it to a non-frozen control wrap during migraine attacks.¹ The 2006 open-label pilot study (n=28) tested a commercial cold gel cap applied during two separate migraine episodes, measuring pain reduction before and after 25 minutes of use.²

Results: In the 2013 trial, neck cooling led to a ~32 % pain reduction at 30 minutes versus increased pain in controls, with 77 % reporting benefit and reduced need for rescue medication. In the 2006 study, the cold gel cap reduced pain scores by about 2.3–2.4 points on the VAS within 25 minutes in both migraine episodes tested, showing consistent short-term relief despite lacking a control group.

Conclusion: Both studies indicate that localized cold therapy, can provide short-term migraine pain relief. While the controlled trial offers stronger evidence, the pilot study supports similar benefits, suggesting cooling caps may be a useful non-drug option, though more robust research, is needed.

Side-effects:

Cooling caps are generally considered safe, but sometimes they can cause a few side effects if not used properly, or used for a longer period of time.

Short-term effects: Ice burns leading to redness, numbness, tingling, and blistering, Skin Irritation.

Long-term effects: Nerve damage

References

1. Sprouse-Blum AS, Gabriel AK, Brown JP, Yee MH. Randomized controlled trial: targeted neck cooling in the treatment of the migraine patient. Hawai'i Journal of Medicine & Public Health. 2013 Jul;72(7):237.

2. Ucler S, Coskun O, Inan LE, Kanatli Y. Cold therapy in migraine patients: open‐label, non‐controlled, pilot study. Evidence‐Based Complementary and Alternative Medicine. 2006;3(4):489-93.