Lidocaine nasal spray may provide some short-term relief during a migraine attack. But there’s not enough evidence to support this treatment, so it’s not commonly used.

Lidocaine nasal spray isn’t a commonly used migraine treatment, but some people find it useful during a migraine attack.

Lidocaine is a local anesthetic used to numb a small area of the body, which helps reduce pain and itching. You may know it best from the dentist’s office. In addition to nasal sprays, lidocaine can be used in a number of different ways. This includes:

  • patches
  • drops
  • injections
  • ointments applied to the skin

Here’s what to know about nasal spray for migraine.

Lidocaine nasal spray might work by numbing a collection of nerve cells in your brain called the sphenopalatine ganglion (SPG). These cells have often been associated with headache pain. They’re also associated with the trigeminal nerve, which is involved in headache pain.

There are SPG cells just behind your nose. They may play a role in symptoms like tearing and nasal congestion, which are common during migraine and cluster headache attacks.

Lidocaine nasal sprays are quickly absorbed into your bloodstream and brain, where they may temporarily numb these cells.

After using nasal lidocaine, migraine relief can occur within minutes. That’s because your nasal cavity contains many blood vessels, which means medication administered as a nasal spray enters the bloodstream quickly.

However, relief is not long lasting. Pain may come back within the hour.

Lidocaine nasal spray is intended for short-term use. Repeated, long-term use of lidocaine can come with serious side effects like abnormal heart rhythm and mental confusion.

Lidocaine nasal spray might help some people with migraine and cluster headache get some temporary relief. But clinical trials have produced conflicting results. Currently, there’s insufficient evidence to support the widespread use of lidocaine.

A 2019 meta-analysis found that lidocaine nasal spray may help alleviate pain and reduce the need for rescue medications in those who experience acute migraine. But because migraine pain may come back quickly, it’s not effective enough for some people.

Research on the use of lidocaine and nerve blocks for migraine are ongoing. Researchers are exploring various techniques of numbing or desensitizing SPG cells to treat migraine in children and adults. This includes injections into the area, laser treatments, and topical gels.

Lidocaine can be used to treat other headache disorders, including cluster headache. When administered nasally through a spray or drops, people with cluster headaches may see a reduction in symptoms like tearing and congestion.

But lidocaine hasn’t shown much promise in tension-type headaches.

Aside from nasal lidocaine, a variety of other localized medications are available for treating migraine.

Other nasal sprays

To help alleviate headache pain, some prescription nasal sprays contain migraine-specific drugs such as:

There’s also one nonsteroidal anti-inflammatory drug, known as nasal ketorolac, that can be used to help relieve moderate to severe migraine attacks. While doctors sometimes prescribe it to treat an acute migraine attack, it’s not indicated for migraine use by the Food and Drug Administration (FDA).

Topical gel

Stopain is a topical gel derived from menthol, which is designed to help relieve migraine pain. A small amount can be applied to the back of the neck and ears up to four times per day.

A 2015 study funded by Stopain’s parent company found that using this gel during an acute migraine attack can reduce headache intensity within 2 hours of application.

Migraine stick

Some people experience symptom relief with an over-the-counter product known as the Migrastil migraine stick. It’s a rollerball filled with essential oils like lavender, peppermint, and spearmint diluted with fractionated coconut oil.

You can apply the migraine stick topically to areas like your temples and the back of your neck. It can be used as needed, ideally no more than every 2 hours. It may irritate sensitive skin.

However, the American Migraine Foundation notes that essential oils are not considered to be an effective treatment for migraine.

Migraine can be treated in a variety of ways. Lidocaine nasal spray or drops may help provide quick relief for an acute migraine attack. However, it’s often best used in combination with other medications to manage migraine pain.