Ice Pick Headaches: Symptoms, Causes and Treatment

Ice Pick Headaches

How would you describe the feeling of having ice pick headaches? It feels like someone stabs you in the face with an ice pick. It’s also known as a stabbing headache.

This type of headache causes sudden, sharp pains that feel like ice picks. There are no underlying causes for stabbing headaches. Their pain lasts for only a few seconds which makes them difficult to treat. You can prevent headaches by taking precautions.

What are ice pick headaches?

Primary stabbing headaches, also known as ice pick headaches, are severe, painful headaches that occur suddenly.

The way they feel is often like having an ice pick stabbed into them, or that they feel like they are being hit repeatedly. The attacks can be excruciating and debilitating and give no warning before striking. Most attacks last no more than a few seconds.

It is possible to have primary stabbing headaches during either sleep or wakefulness. Also, they can affect different parts of your head at different times throughout the day.

Other names for ice pick headaches include:

  • Primary stabbing headaches
  • Idiopathic stabbing headaches
  • Jabs and jolts
  • Opthalmodynia periodica
  • Short-lived head pain syndrome
  • Needle-in-the-eye syndrome

Find out what causes ice pick headaches, how they are treated, and the symptoms that you may experience.

Read: Exercise Headaches

What are the symptoms of an ice pick headache?

Some of the symptoms of ice pick headaches are listed below. The symptoms are:

  • Typically lasts around three seconds, sudden, stabbing head pain
  • Rarely lasts for more than a minute
  • Extremely painful to a moderate degree
  • Attacks that come frequently and in waves
  • Approximately 50 stabs a day
  • Unpredictable stabbings
  • Headaches usually feel worse at the front, top, or sides of the head
  • An attack that takes place in multiple places on the head, one after another
  • Symptoms include pain on either side of the head

Sometimes, ice pick headaches are related to cluster headaches or migraine headaches, but they differ from these conditions. Ice pick headaches don’t cause any involuntary signs such as:

  • Facial flushing
  • Drooping eyelids
  • Tearing

Read: Hormonal Headaches

Ice pick headaches vs. migraine attacks

Headaches caused by migraine attacks are debilitating and intense. Ice pick headaches usually last only a couple of minutes, but they can last days or even weeks.

There is usually only one side of the head affected by migraines. Symptoms that precede migraine pain include:

  • Tingling in the face
  • Blind spots
  • Light flashes, called a visual aura

It is common for migraine attacks to result in nausea, vomiting, and increased sensitivity to light or sound.

Ice pick headaches vs. cluster headaches

Headaches that occur in clusters are called cluster headaches. These happen often during sleep, affecting the side of the head around one eye.

They can be likened to primary stabbing headaches, except that they usually begin with migraine symptoms or a migraine attack.

A cluster of them may occur over a period of weeks to months, as suggested by their name. Symptoms include the following:

  • Redness and tearing in one eye
  • Drooping eyelid
  • Inflammation around the eye
  • Runny or stuffy nose

Moreover, ice pick headaches are quite different from tension headaches, which are usually mild to moderate in intensity and often encircle the entire head.

Read: Post-Traumatic Headache

Causes and triggers of ice pick headaches

Ice pick headaches are currently not fully understood but are thought to be associated with temporary disruptions of the brain’s central pain control mechanism.

Research indicates that ice pick headaches are more common in women than men, and they occur in 2 to 35 percent of the population.

In a study that was conducted at Samsung Medical Centre Headache Clinic in 2017, 65 patients admitted to the department with primary stabbing headaches ranged in age from 25 to 83 years old, with a median of 54 years old.

It is common for migraine sufferers and people with cluster headaches to have ice pick headaches more often than the average person does.

The cause of cluster headaches is unknown, much like that of primary stabbing headaches. Migraine sufferers, as well as those who get ice pick headaches, may be more successful in identifying their triggers. Some triggers can include:

  • Stress
  • Sleep disruptions
  • Alcohol, particularly red wine
  • Changes in hormones
  • Food additives

Read: New Daily Persistent Headache

Associated conditions and complications

It’s important to note that ice pick headaches can sometimes be classified as primary headaches, which means they’re caused by the headache condition and not by another concurrent condition. Secondary headaches also have an underlying cause.

Conditions that contribute to these causes include:

  • Migraine: Ice pick headaches are more common in migraine sufferers. Those suffering from migraines may also experience ice pick headaches in the same part of the head.
  • Cluster headaches: Sometimes cluster headaches end with ice pick headaches.
  • Temporal arteritis: The arteries that provide blood to the brain and head are affected by this condition. The untreated condition can result in stroke, brain aneurysms or even death.
  • Intracerebral meningioma: It can develop either on the surface of the brain or on the spinal cord. Tumors of this type affect a variety of brain regions. They can be treated using radiation, observation, and surgery.
  • Autoimmune disorders: In a study published in 2012, an autoimmune disorder such as multiple sclerosis, lupus, and autoimmune vasculitis was associated with ice pick headaches.
  • Bell’s palsy: An injury or trauma to the nerves of the face can result in Bell’s palsy, a form of temporary facial paralysis.
  • Shingles: It may lead to secondary headaches such as ice picks due to a viral infection of the nerves.


Many headache types are associated with ice pick headaches, which can make diagnosis difficult.

Clinicians usually make their diagnosis based on your symptoms. During the diagnostic process, doctors refer to the International Classification of Headache Disorders, the third edition for symptoms and criteria.

If you always experience headaches on the same side or if your symptoms are atypical, a scan may be necessary to exclude other conditions.

Read: Sinus Headache

Primary stabbing headache treatment

When an ice pick headache occurs, there isn’t enough time for the medication to be taken.

However, it makes sense to use pain-relieving medication regularly if you often get attacks. Prophylactic medications can help you avoid headaches in the first place.

Consult your doctor for help in determining which medication is right for you.

The following medications can be considered by you and your doctor:

  • Indomethacin. The drug indomethacin acts as a nonsteroidal anti-inflammatory drug (NSAID), reducing pain by blocking inflammation. The medication is prescribed for treating headaches, such as ice pick headaches and migraines. The medication doesn’t work for about 35 percent of people with ice pick headaches.
  • Melatonin (N-acetyl-5 methoxy tryptamine). No prescription is needed for melatonin. Melatonin reduces insomnia and headaches.
  • Gabapentin. The medication gabapentin is commonly prescribed as both an anticonvulsant and as a nerve pain reliever.

If you suffer from ice pick headaches, it might be helpful to maintain a daily diary detailing your daily activities, emotions, food intake, and ice pick headache events. You can also use apps to keep track of these things. You may find it helpful to avoid specific triggers if you’re able to identify them.

Complementary treatments, such as acupuncture, may minimize migraine attacks and decrease the incidence of primary stabbing headaches.

Read: Chronic Tension Headache

When to see a doctor

It makes sense to consult your doctor if you have ice pick headaches as they are sometimes caused by other conditions. It’s important to exclude any more serious conditions that might present similar symptoms.

Ice pick headaches can be severe but are rarely dangerous. The only time you need medical attention is if they are frequent or impede your daily life. If you experience them frequently, you should take steps to avoid them since they occur without warning.

If you experience an unexpected stab of pain while operating machinery, driving a vehicle, or engaging in another activity that might cause serious consequences, it might be a good idea to seek medical attention.


The central pain control mechanisms of the brain may malfunction in people with primary stabbing headaches. Some people get ice pick headaches more often than others, particularly women and people suffering from migraines or cluster headaches.

These headaches are not dangerous, but they can be debilitating. Talk with your doctor if they are affecting your quality of life. You might be able to get medications or treatment that may help.

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