Modification of therapeutic temperature range in cryotherapy could improve clinical efficacy in tension type headache

BACKGROUND: Cold pack therapy is not used frequently in clinics in spite of its effectiveness in clinical reports. Low compliance due to cold intolerance may be a disturbance factor that hinders patients from using the modality. OBJECTIVE: To demonstrate the improved compliance and clinical efficacy as new devised cold modality with a different composition is applied to target different therapeutic temperature range in tension-type headache (TTH) patients. METHODS: A randomized, controlled, comparative trial involving 53 patients with tension-type headache was conducted. A new cold modality that targets upper normal therapeutic temperature range was devised and applied to one group (n = 27) and ice pack was applied to the other group (n = 26). RESULTS: After application of two modalities for 4 weeks, the amount of analgesics intake, modality use per week, and Likert survey of cold intolerance were significantly different between the two groups. CONCLUSIONS: Rather than focusing on lowering the skin temperature indefinitely, optimizing tolerability by targeting the temperature at the upper therapeutic range could be more effective in cold modality application.