Ice Pick Headache (Primary Stabbing Headache)

What is an ice pick headache (primary stabbing headache)?

An ice pick headache is an uncommon headache disorder. It causes a sudden, sharp, stabbing head pain (or a quick series of pains). This pain comes on unexpectedly and lasts a few seconds.

People who have these headaches equate the pain to being stabbed in the head or eye with an ice pick.

The medical term for ice pick headaches is stabbing headaches. Other terms include:

• Jabs-and-jolts syndrome.
• Needle-in-the-eye syndrome.
• Ophthalmodynia periodica.
• Sharp, short-lived head pain.

How common are ice pick headaches?

Some studies suggest that only about 2% of people worldwide experience these headaches. But one Norwegian study found that 1 in 3 people had ice pick headaches.

Who is at risk for ice pick headaches?

People of all ages and genders can get ice pick headaches. Women who get migraine headaches are more prone to them. In 1 in 3 instances, the ice pick headache occurs in the spot where migraine pain originates.

What causes ice pick headaches?

Experts aren’t sure why some people get ice pick headaches. All types of headaches have primary and secondary causes:

• Primary headache: People with primary ice pick headaches experience head pain without other symptoms. There isn’t an underlying condition causing the pain.
• Secondary headache: A health condition, such as shingles, meningioma (brain tumor) or multiple sclerosis, causes the ice pick headache along with other symptoms.

What are the symptoms of ice pick headaches?

An ice pick headache may cause a single stabbing pain or a series of quick pains. In 8 out of 10 instances, each stabbing pain lasts less than three seconds.

These head pains:

• Happen without warning.
• Move from front to back (or back to front) on the same side of the head.
• Move from right to left (or left to right) on either the front or back of the head.
• Occur sporadically once a day or several times a day. It’s rare to get ice pick headaches over several consecutive days.

How are ice pick headaches diagnosed?

Your healthcare provider can diagnose ice pick headaches based on your symptoms. Rarely, ice pick headaches are a sign of an underlying problem like a brain tumor.

Your provider may order an MRI or another imaging test to check for health conditions. But most people with ice pick headaches don’t need this type of testing.

Your healthcare provider will also want to rule out other headache disorders that cause similar symptoms. These include:

• Nummular headache: This headache causes pressure-like pain in a coin-shaped spot in the head.
• Occipital or cranial neuralgias: Inflamed occipital nerves in the scalp cause occipital neuralgia. You may have shock-like pain in the back of the head, behind the ears or the upper neck.
• Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT): This rare headache disorder causes pain around one eye. The eye becomes red and watery (conjunctivitis). You may also have a runny nose and nasal congestion.
• Short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA): Similar to SUNCT, this disorder causes eye pain with or without redness and tearing. With SUNA, an eye may be red but not watery. Or the eye may be watery but not red.
• Trigeminal neuralgia: Nerve inflammation causes pain like electrical shocks to the lower face and jaw. People with trigeminal neuralgia may also have pain around the nose and above the eyes.

How are ice pick headaches managed or treated?

Ice pick headaches disappear quickly. They aren’t like other headaches or migraines, which can last for hours or linger for days.

There isn’t time to take pain relievers to treat ice pick headaches. By the time the medicine kicks in, the ice pick headache is long gone.

Instead, treatments focus on preventing pain. Preventive steps include:

• Headache medications taken daily to ward off head pain like migraines.
• Melatonin to reduce migraine frequency.
• Prescription nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin (Tivorbex®), to minimize headache pain when it occurs.

How can I prevent an ice pick headache?

The same steps you might take to prevent other headaches or migraines may also lower your risk of ice pick headaches. Don’t overdo it with pain medicine. You can develop medication overuse or rebound headaches.

You can also:

• Eat a healthy diet and try not to skip meals.
• Get more sleep.
• Limit your caffeine and alcohol.
• Manage stress through exercise and relaxation techniques like yoga and meditation.
• Quit smoking and using other tobacco products.
• Try therapies like biofeedback or acupuncture.

What is the prognosis (outlook) for people who have ice pick headaches?

Ice pick headaches come and go quickly. They aren’t as debilitating as chronic migraines or headaches. Still, you should see your healthcare provider if head pain lasts several days or interferes with your ability to work or complete daily activities.

When should I call the doctor?

You should call your healthcare provider if you experience stabbing head pain and:

• Balance problems.
• Dizziness.
• Nausea and vomiting.
• Vision problems.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What is causing my head pain?
• How can I prevent ice pick headaches?
• What is the best treatment for me?
• Should I look out for signs of complications?

A note from Cleveland Clinic

Because ice pick headaches happen sporadically and go away so quickly, many people don’t tell their healthcare providers about them. But these headaches may be more than a painful nuisance. In rare instances, they’re a sign of a more serious problem. You should share your symptoms with your provider. They can find what’s causing the pain and work with you to prevent head pains.