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zoom RSS 片頭痛に対する冷却療法

<<   作成日時 : 2010/07/08 23:42   >>

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冷蔵パックは片頭痛の痛み和らげることができるだろうか?
画像 数百万人の片頭痛患者は処方薬や市販薬で治療するが、他のオプションとして、メンソレータムから出ているWellPatchパッドは4枚で約4ドルで手に入れられる。
 痛み出したら額に貼り付けると、開封すると蒸発し始める水っぽいゲルでできているパッドがハッカの香りとともに皮膚を冷却する。最高8時間持続するという。よく似た製品の小林製薬から出ているBe Kooolパッドは1枚1ドルで販売されている。Thera-Medのバンド製品は再利用可能な冷凍室で冷やすタイプの10ドル弱の製品である。
 冷却により、頭痛患者の50-60%に効果があるという。Dr. Frederick Freitagによれば、約25年前に冷凍ゲルが頭痛患者の約70%に効果があったという研究をし、即効性があるという。部分的に心理学的な影響かもしれないともいう。
 ウィスコンシン大のDr. Roland Brillaによれば、19世紀以来頭痛の治療として冷却が行われてきており、試すことへの否定的側面はないが、極めて効果的というわけではないという。投薬に取って代わると言うわけにはいかないだろう。
------------------
検索すると、冷却療法についての研究は結構あり、効果もそこそこ出ている。

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Can cold packs ease migraine pain?
Though cooling products like Thera-Med Headache Band and WellPatch and Migraine Be Koool pads may offer some headache relief, don't expect to throw out medication altogether.
By Chris Woolston, Special to the Los Angeles Times
July 5, 2010
http://www.latimes.com/news/health/la-he-skeptic-20100705,0,6019972.story

Migraine BeKoool pads stick directly to the forehead and cool the skin through evaporation. (Ricardo DeAratanha / Los Angeles Times)

The word " headache" doesn't really do justice to a migraine. Migraines don't just ache; they take over. Once the pain starts, it's hard to think about anything else.

Millions of migraineurs tackle their pain with prescription or over-the-counter drugs. But there are other options. For about $4, you can buy a pack of four WellPatch Migraine pads from Mentholatum. Users are instructed to stick a pad on their forehead as soon as pain starts. The pad is filled with a watery gel that starts evaporating when the package is opened. The evaporation cools the skin beneath the pad, a sensation that's enhanced by a subtle scent of menthol. According to the package, the cooling lasts up to eight hours.

Migraine Be Koool pads, a very similar product from Kobayashi Healthcare, also sell for about $1 each. Like the WellPatch Migraine pads, Migraine BeKoool pads stick directly to the forehead and cool the skin through evaporation. And, like the WellPatch, they have a little menthol for extra cooling.

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The Thera-Med Headache Band from Carex takes a colder approach to migraine relief. Unlike the WellPatch or Be Koool pads, it chills out in the freezer or refrigerator when not in use. The band, which is held in place with Velcro straps, contains a "micro-gel" that freezes without hardening. One side of the band is covered in fabric for a more gentle cool-down, kind of like wrapping a towel around an ice pack. People who want extra cold can use the side without the fabric. Expect to pay less than $10 for each band, which can be reused indefinitely.

The claims: The WellPatch website says that the pad "cools and soothes the discomfort associated with migraine." Todd Cantrell, director of marketing at Mentholatum, clarifies that the pads don't really treat the migraine itself but can make the whole experience a little more bearable.

The website for Migraine Be Koool says that "nothing provides more immediate and soothing relief to migraine headaches than Migraine Be Koool." Kobayashi Healthcare didn't respond to requests for comment.

The Thera-Med website says that the band "helps relieve migraine, tension and sinus headaches." It also says that "researchers have found that cold treatment is shown to be effective in 50-60% of headache sufferers." Fred Thiemann, a product manager for Carex, notes that "many people spend lots of money on drugs for headaches," adding that the pad could "solve their problem" at a fraction of the price.

The bottom line: Cold isn't a miracle cure for migraines, but it can definitely bring some relief, says Dr. Frederick Freitag, co-director of the Diamond Headache Clinic in Chicago. In fact, he co-authored a study published nearly 25 years ago showing that frozen gel packs helped about 70% of headache patients who tried it. About half said that the relief was immediate.

Freitag says that commercial headache pads could be worth a try. "I'm sure they help some people," he says, adding that the relief might be at least partly psychological. He's not convinced that the WellPatch or Be Koool pads could get cold enough to "really make a difference." Still, the mere suggestion of cold could be soothing for some people, he says.

Cold packs like the Thera-Med band could potentially bring even more relief, Frietag says, but he points out that there's an even cheaper, easier option: "I tell patients to pick up a bag of frozen peas and wrap it in a towel." They can reuse the bag as often as they like, he says, and they can place it where it hurts (usually one of the temples) instead of the forehead.

"Cooling has been used [for headaches] since the 19th century," says Dr. Roland Brilla, a clinical assistant professor of neurology at the University of Wisconsin School of Medicine and Public Health in Madison and a member of the American Headache Society. Though many patients say cold helps a bit, he cautions that "it doesn't seem to be extremely effective."

There's no downside to trying a headache pad, Brilla says. But, he adds, if patients think they can trade in their medications for a little chilly headwear, they're bound to be disappointed.

Curious about a consumer health product? Send an e-mail to health@latimes.com.

Read more at latimes.com/skeptic.

Copyright (c) 2010, The Los Angeles Times

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Evid Based Complement Alternat Med. 2006 Dec;3(4):489-93. Epub 2006 Jun 15.

Cold Therapy in Migraine Patients: Open-label, Non-controlled, Pilot Study.

Ucler S, Coskun O, Inan LE, Kanatli Y.
Abstract

Some patients with headache report that they have frequently used physical therapies such as application of cold to relieve their headache. There are only a few reported studies related to cold therapies in patients with migraine. In this study, we investigated the effect of cold application on migraine patients. Twenty-eight migraine patients were included. Cold therapy was administered to them by gel cap. Patients used this cap during their two migraine attacks. Before and after the cold therapy, headache severity was recorded by using visual analogue scale (VAS). Patients used this cap for 25 min in each application. They recorded their VAS score just after the therapy and 25 min, 1 h, 2 h and 3 h later. Two patients could not use this therapy due to side effects (one due to cold intolerance and one due to vertigo) in both applications. Therefore, therapeutic efficacy was evaluated in 26 patients. Twenty-five minutes after treatment of the first attack, VAS score was decreased from 7.89 +/- 1.93 to 5.54 +/- 2.96 (P < 0.01). Twenty-five minutes after treatment of the second attack, VAS score was decreased from 7.7 +/- 1.8 to 5.4 +/- 3.55 (P < 0.01). Cold application alone may be effective in some patients suffering from migraine attacks. Its combination with conventional drugs should be investigated in future studies.

PMID: 17173113 [PubMed - in process]PMCID: PMC1697736
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Headache. 1989 Oct;29(9):598-600.

Cryotherapy for headache.

Robbins LD.
Abstract

45 patients with migraine or migraine plus chronic daily headache evaluated the effectiveness of a coldwrap for headache relief. 35.5% judged it not effective, 29% judged it mildly effective, 26.5% found it moderately effective, and 9% judged it completely effective. Previous studies on ice treatment for headache are reviewed.

PMID: 2584002 [PubMed - indexed for MEDLINE]
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Postgrad Med. 1986 Jan;79(1):305-9.

Cold as an adjunctive therapy for headache.

Diamond S, Freitag FG.
Abstract

We report the results of a study conducted recently at the Diamond Headache Clinic, Chicago, on the effectiveness of application of cold as an adjunctive therapy for acute headache. Ninety clinic outpatients were divided evenly into three groups according to headache type--migraine, cluster, and mixed. They used the standard headache medication for two attacks and the standard medication plus application of cold with a reusable, frozen gel pack for two attacks. There was no significant difference in patient response to the gel pack by headache type. Seventy-one percent of patients considered the pack effective; 52% reported an immediate decrease in pain, and 63% reported an overall decrease in pain. Seventy-one percent of patients intended to use the gel pack in the future. Use of such gel packs, which are available commercially, does not damage the skin. Our study indicates that cold application does provide some symptomatic relief of headache; it may also offer psychological alleviation of the pain.

PMID: 3941818 [PubMed - indexed for MEDLINE]


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