Migraine is a neurological condition with a substantial global health impact, particularly affecting women during reproductive years. While medications remain central to treatment, non-pharmacological methods are gaining attention due to side effects, limited drug effectiveness, and contraindications during pregnancy or for individuals with chronic conditions (Haghdoost & Togha, 2022).

Cold therapy, manual therapies, lifestyle changes, and supplements represent promising alternatives or adjuncts in migraine management.

Recent systematic reviews and pilot studies suggest that cold therapy offers short-term pain relief during migraine attacks. Applications like cold gel caps and wraps reduced pain severity within 30 minutes in about 50% of participants, with some showing consistent benefit across multiple attacks (Ucler et al., 2006; Hsu et al., 2022).

However, the long-term impact on symptoms like nausea and recurrence remains less clear, and studies vary in methodology. Beyond cold interventions, other effective non-pharmacological strategies include trigger avoidance, sleep regulation, and behavioral therapy. Identifying personal migraine triggers - such as stress, sleep disruption, dietary patterns, or environmental stimuli - can help patients prevent attacks.

Techniques like biofeedback, cognitive behavioral therapy, and relaxation training show grade A evidence for reducing migraine frequency. Manual therapies, including massage and spinal manipulation, may also be as effective as certain prophylactic medications, though evidence is still developing (Chaibi et al., 2011).