Ice Pick Headache Signs and Symptoms

People who suffer from migraine symptoms or cluster headaches are more likely to experience what's known as an ice pick headache—a sudden, stabbing pain that hits with no warning.

Ice pick headache

You'll know an icepick headache when one hits you.

Photo: Dreamstime

An ice pick headache—the type that causes a stabbing pain and usually centers in the temple area or around the eyes—is very rare. For most people, thankfully, it’s brief. In 80 percent of ice pick headache sufferers, symptoms last from one to 10 seconds. For those prone to ice pick headaches, however, they can occur several times a day.

Another symptom you may notice with an ice pick headache is that you develop swollen, watery eyes and drooping eyelids, with pupil constriction in one or both eyes. You also may notice accompanying nasal congestion.

Because ice pick headaches strike so fast and usually resolve rapidly, treating them isn’t easy. They often will have dissipated before you can take any painkilling medication.

The cause of ice pick headaches (sometimes written as “icepick” headaches) is unknown. Some research suggests, however, that they may be related to head injuries.

Diagnosing Ice Pick Headaches

When it comes to diagnosing your ice pick headaches, your doctor will be guided by the information provided in the International Classification of Headache Disorders (ICHD). The ICHD is also used to diagnose other types of headaches, including migraines, tension headaches, and cluster headaches (you can access it yourself at www.ichd-3.org).

The ICHD classifies headaches based on clinical and laboratory observations. For ice pick headaches, it notes other terms that have been used to describe this type of headache—for example, ice-pick pains, jabs, and jolts, needle-in-the-eye syndrome, ophthalmodynia periodica, and sharp but short-lived head pain.

ICE PICK HEADACHES: DID YOU KNOW…

  • …that ice pick headaches are not thought to involve the trigeminal nerve, which is the largest cranial nerve and transmits sensations from the face to the brain? The trigeminal nerve does, however, play a role in migraine symptoms, meaning that if you suffer from migraines, you’ll feel pain in your face.
  • …that ice pick headaches move from one area of the head to another in about 70 percent of cases? In about one-third of all patients, though, these headaches occur in one area of the head. If you suffer from ice pick headaches in the exact same spot and they happen often, your doctor may refer you for a diagnostic test (such as magnetic resonance imaging) to make sure there isn’t an underlying structural reason for your headaches.

The ICHD describes ice pick headaches as “transient and localized stabs of pain in the head,” and notes also that these headaches occur spontaneously, without any evidence of disease in the underlying structures of the face, or of the cranial nerves.”

The diagnostic criteria it provides for your doctor are as follows:

A. Head pain occurring spontaneously as a single stab or series of stabs, and fulfilling the next three criteria (B through D).
B. Stabs that each last for up to a few seconds.
C. Stabs that recur with irregular frequency, from one to many per day.
D. No cranial autonomic symptoms.
E. Symptoms that aren’t better accounted for by another ICHD-3 diagnosis.

Treating and Preventing Ice Pick Headaches

If you’re prone to ice pick headaches, there are a number of steps you can take to try to prevent them.

Since they tend to occur alongside migraines and cluster headaches, they may respond to medications that treat those types of headaches.

One option for ice pick headache treatment is indomethacin (Indocin), a nonsteroidal anti-inflammatory drug (NSAID) similar to ibuprofen (Advil, Motrin). Indomethicin must be taken sparingly, however—particularly by people with heart disease, since long-term use is associated with a greater risk for heart attack and stroke. Since indomethacin is an NSAID, other side effects also are possible—for example, gastrointestinal bleeding. It also has been linked to eye problems, so if you take it you should have regular (at least annual) eye exams.

There also is evidence that melatonin supplements (which can be used to help prevent jetlag) may be effective for easing an ice pick headache. And boost your intake of foods that naturally contain melatonin—these include pineapples, bananas, oranges, sweet corn, and tomatoes.

Meditation and other stress-relief options also may reduce the frequency of ice pick headaches, according to research.


Originally published in 2016, this post is regularly updated.

Comments
  • I have experienced these Icepick described pains for many years. They have always occured in exactly the same spot in my head at (L) hemisphere slightly back from the Paracentral sulcus. I was about aged 21 when the first started to occur. I did not seek medical advice because the severe discomfort only lasted for About 2 seconds and perhaps 3 at the most. When I was 24 years of age I was on holiday in Filey and went swimming in the sea and suffered the worse attacked of icepick I had ever had. It was very very severe and I remember thinking the pain was like extreme but still very pinpointed. I came out and went to my hotel and I was unable to properly lift my head for nearly a week. If I did rise from my bed and bent foreward I experienced instant headache. After my holiday I returned to my living accomodation and I was still unable to make up my Divan bed due to its low to the ground design. I gradualy recovered and was able to return to work with no further problems. I often think back to that time and do wander if I actualy experienced a trauma more serious than it appeared. After that, the attacks returned to their normal periods between attacks. I generalyexperience attacks about ever 6 weeks or so and may have 2 or 3 on the same day, and sometimes only 1 more often only 1. I developed a mild idiopathic adolescent developmental scoliosis in my lumba region at age 17/18 years resulting in Lordosis to my (L) side. I a.m now Aged 75 and although i continue to experience Icepick attacks they do seem to be decreasing in occurance. I hope this may be of some Help with your Research

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  • Today is June 3, 2018. I turned 76 on April 8, 2018. I too have reoccurring ice pick headaches since year 2013. They returned about two weeks ago so here we go again… Rest whether sleep or just sitting casual seems to provide reasonable relief for varying periods of time. I was born with scoliosis and recently diagnosed with lumbar spinal stenosis.

    Reply
  • For many years I have suffered what I believe are Ice Pick headaches. No medical person has offered any advise or offered any medication. I get about 5 a year and they last about 5 to 7 days, with no warning. Pain medication helps a little if I keep taking it. Sometimes the pain is so bad it makes me scream and other times it makes my whole body jump or twitch. My head is always has a localised sore spot. Towards the end of the attack the sore spot and pain seems to get larger and gradually fade away. The attacks are in random places in the head and I have had one really bad. One in my cheek. Any suggestions welcome.

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  • Yup, sharp pain over right ear, periodic over the past 4+ hours, very brief. Have had them before, but not frequent. Interestingly, am not a classic migraine person, but do periodically get a type of stress headache, and mother claimed migraines.

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  • I have had ice pick headaches since I was around 30. I am now 69. Sometimes they come and go lasting seconds to 1 to 2 days. I was hospitalized when I was 50 with a 104 temperature and at that time I thought and wanted to die. No medication helped they just spontaneously stopped I was recently diagnosed with simple partial seizures and was put on Trleptal which helped with the seizure activity as well as the stabbing pain that can bring you to you knees when they come and go like 5 in a row. I went for a second opinion tonight and this neurologist is sending me for an mri/mra. I will go back for the results and he said he will give me 2 injections in the back of the head. It’s considered a nerve block for which he said shoul help. So with this said if anyone reads this this is my email. Feel free to write. I pray for each one of you to find some peace and relief in this pain that we endure. Diane

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  • I have suffered from ice pick headaches since I was 7 years old. Got my first one swimming under water and got such a fright. Then got them about once every 6 months. I am now 35 and have been getting one a month for the last 5 years. I have done a lot of research and decided to try some natural ways of stopping them. I take 3mg of melatonin each night and have also been taking organic honey mushroom and lions mane which I bought on mushroomnutrition.com and I have not had an ice pick since I started these. It has now been over 6 months. Thought I would share this as I know how traumatised I feel after one and no one understands. They think because they only last less than a minute it’s not a big deal but I am scared of when the next one will come. Taking the melatonin and mushrooms have changed my life. Good luck to you all. Lorna

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  • Had these for decades. Used to call them knitting needle headaches as it felt as if someone were sticking a needle deep into my brain. Lasts a second or two by makes me flinch. Had an attack yesterday – lasted for about 7 hours until I went to sleep but feel a little washed out today. They usually strike just behind or above the ear, either side of the head and attacks are very random. I might get another tomorrow or I might go months without any. Sometimes they last half an hour although they generally last at least several hours. Sometimes they have gone on for a few days though thankfully that’s fairly rare. These are self-diagnosed by the way. I’m 56 and in good health otherwise, not particularly active and wonder if posture etc has an effect as I write for a living and so sit in front of a computer all day. I wouldn’t say I suffer from stress particularly and I have tried to find a pattern to it, ie if it happens after certain food, in tandem with particular sleep patterns etc but they seem completely random. The only other point of note – which probably has absolutely nothing to do with it, is that I carry a genetic disorder.

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  • I had my episode when I was 30, and they occured like every 1-2 months Each stab lasts only a second, each episodelasts for 2-3 days with stabs every 5-20 seconds. The pain is mostly over my right ear, but sometimes in front of my right ear or oright over my left ear. I never know when they come so my body twitches and jolts for every stab. I have found out that if I press my index finger at the point where the stab comes, it eases the pain. Usually I end up taking pain killers since its impossible to have one hand occupied for three whole days. I am currently 60 and three of my daughters also have these headaches. One of them also has migraines with auro. My mother has migraines. For the last three years I have been taking triple dose of ASEA (Suplementation of Redox Signaling Molecules) and have had only 3 or 4 mild episodes.

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