Cold Stone Therapy for Migraine Headaches

Pain, no matter where experienced or what the cause, can disrupt a person’s life on a variety of levels. From time away from work to missing time with family and friends, pain is often debilitating. But you can help. As more research confirms the benefits massage therapy has to offer, pain management is an area where massage continues to show promise. And the pain associated with migraines is no exception. Each year, approximately 50 million people in the United States suffer from migraine headaches, and two-thirds of sufferers are women. That’s a lot of people in pain—and a lot of people you can reach with the message that massage therapy can help.

Common Migraine Features

Pain. For a headache to be classified as a migraine, the pain must be severe enough to limit or impair normal activity and be intensified by physical exertion. Migraines typically have some common features, including pain that is only on one side of the head but may shift sides during the same headache. Sufferers might also experience a pulsing or throbbing pain that generally lasts four to 72 hours. 

Pre-headache. Approximately 25 percent of migraine sufferers have a classic kind of headache. The prodrome— or pre-headache—may be experienced hours or even days before a migraine episode. Being able to recognize these symptoms can help massage therapists better assess a client’s pain and, in some cases, prevent a full migraine from occurring by properly managing pain early. 

Classic symptoms of a pre-headache include a visual perception of flashing lights, wavy lines or spots, a partial loss of sight, tingling or a numbness of the face, confusion, hypersensitivity to light and touch, feeling heavy on one’s head and sharp pain in one area. Typically, these symptoms last from five to 10 minutes before subsiding, replaced by the throbbing, intense migraine headache. 

How Can Massage Help?

A three-pronged approach that includes aromatherapy, massage therapy and cold therapy can be effective in helping relieve the pain of migraine for many sufferers. 

Aromatherapy. The first step in stopping a migraine is to calm the client, and one effective way to achieve this goal is through aromatherapy. Depending on the trigger, you can have clients breathe different blends of oils. For example, if the client knows the migraine is the result of stress, try using essential oils of clary sage, spikenard, helichrysum and lavender. For an environmental trigger, you might try roman chamomile, lavender, peppermint and rosemary. 

Have the client breathe from each vial of oil, one at a time. Whatever they find most appealing, use this oil during the massage session. 

Massage. After choosing an oil, you’ll want to perform a series of headache point release techniques to help the client reach a calmer state. As a caution, you do not want to increase the blood flow to the neck and head, as doing so may result in accelerating the migraine pain. You may find that clients who are suffering from a migraine have several trigger points and very tight necks, and although not working on these areas sounds counterintuitive, the best thing to do is leave these areas alone for now.

Instead, the goal is to decrease blood flow, and stimulating these areas at this point can have the opposite effect. My research has shown that cranial sacral techniques are a wonderful accompaniment at this point in the treatment. After the headache is gone, at another treatment time, I suggest the therapist work the tight areas to help prevent future headaches.

Cold therapy. The third phase of the treatment is to address the vascular component of the migraine. The therapist will need to try to reduce the overabundant blood flow to the head and brain with cold stones, thereby normalizing the blood flow. In doing so, the therapist will be reducing or removing the pounding sensation the client is experiencing in their head while helping to calm the brain. My own experience suggests that positioning specifically designed marble stones, cooled to approximately 36 degrees and applied to specific areas of the face and neck, has the desired effect. Many migraine sufferers love the feeling of the cold stones, and within a short amount of time start to feel relief. 

Timing and triggers. If at all possible, massage therapists will want to see the migrainer the day they feel the symptoms coming on because timing is critical to ward off the migraine before it can take full effect.

With busy schedules, however, you may not always be able to see a client right as they notice the symptoms. You can work alongside the client to try and figure out some of the triggers that cause migraine. Are they mostly occurring when the person has a particularly stressful week at work? Or maybe they notice that many of their migraines are happening when they eat certain foods. 

Whatever the trigger might be, being more aware of when a migraine may be more likely to happen can help both you and the client anticipate when a massage therapy session might be needed.

Quick Facts About Migraines

  1. Migraine attacks go beyond the symptoms of a normal headache and
    require serious attention.
  2. Often referred to as a spreading depression, migraines that start in a central location can rapidly spread.
  3. A spreading depression can move into the trigeminal nerve (cranial nerve that affects the face), causing the blood vessels of the brain to constrict and then dilate continuously.
  4. Migraine attacks can occur daily and can be devastating to the sufferer’s ability to function normally.
  5. People with migraines can be more susceptible to epilepsy.


Always remember that if the headache is so severe that a client can’t stop vomiting, or if the headache suddenly becomes severe, referring a client to their primary care provider is imperative. Or, if migraine is a new development for a current client, you need to make sure they have consulted with their primary care physician and been cleared for massage therapy before providing massage. 

If they have commonly suffered with headaches, are familiar with their symptoms, and have seen their health care provider and ruled out any medical issues, there are still cautions and contraindications massage therapists need to account for, including headaches that appear in a new pattern or have a gradual onset but aren’t getting any better. 

Massage therapists should also practice extreme caution with clients who exhibit additional symptoms that could point to infections such as meningitis or encephalitis, or nervous system injury, like stroke, aneurysm or a tumor. These symptoms would include slurred speech, numbness in any region of their body or difficulty with motor control, for example. 

Massage therapy is known to help people manage pain. From injury to arthritis, the ways in which consumers are beginning to use massage therapy to better find relief are growing. For those clients who regularly suffer from migraines—or new clients who come with a history of migraines—massage therapy can be a real benefit.

Common Causes

Although the exact causes of migraines aren’t well understood, we do know that many people have some common triggers, including food allergies, caffeine addiction, environmental stimulation, stress and hormonal imbalance.

Continue Learning: Helping Clients Manage Migraines

3 Credit Hours

Learn how massage therapy can help clients who suffer from migraines and the special considerations to keep in mind in this online course. Find ways to market the benefits of your services to this population, and get detailed information on migraine types, phases, triggers, symptoms and common approaches to best help your clients.

Register now »

Kelly Lott graduated from the Chicago School of Massage. She has been a massage therapist for 23 years and is a nationally certified educator with NCBTMB. For more information, visit her website.

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