Ice pick headaches, or primary stabbing headaches, are sharp, painful headaches that start and end suddenly. They can feel as if they are around the eyes or temples, or moving side to side. They are called an ice pick headache because they consist of a jabbing, jolting pain that feels like an ice pick. They tend only to last a few seconds, up to a minute. Sometimes they occur once, or they may reoccur in the same or different spots.

Causes of Ice Pick Headaches

There are two kinds of ice pick headaches: primary ice and secondary. Experts are unsure of the cause of primary ice pick headaches. There are theories that they occur due to a brief disruption in how the brain controls pain. They could also be due to nerves, blood vessels, or muscles in the head and neck, and genetics may place a role. Secondary ice pick headaches can occur as the result of various conditions, for example, shingles or Bell’s palsy.

Symptoms of an Ice Pick Headache

The symptoms of ice pick headaches are stabbing pains in the head that appear and disappear suddenly. Often, they last about three seconds but can last up to a minute. These pains can move around the head. Ice pick headaches can occur once or numerous times in a day. People who experience other symptoms in addition to this shooting pain may be experiencing a different kind of headache.

Risk Factors and Triggers for Ice Pick Headaches

People who get migraines or cluster headaches are much more likely to experience ice pick headaches, as well. It is possible that various lifestyle factors trigger the events, such as stress, diet, routine changes, sudden movement, or changes in light. It can be helpful for people seeking a diagnosis to keep a diary of their headaches and potential triggers.

Diagnosis of Ice Pick Headaches

There is no diagnostic test for this kind of headache, so the diagnosis will be made based on the presence of the signs and symptoms the patient experiences. Doctors will attempt to rule out any other cause for the headaches. There can sometimes be confusion between ice pick headaches and other types of headaches, which can mimic the former.

Treatment for Ice Pick Headaches

Because ice pick headaches are so short-lived and usually do not occur more than a few times a day,  there is no specific treatment. Rarely, they can occur with such frequency that the individual requires treatment. In these cases, one can take non-steroidal anti-inflammatory drugs (NSAID). These drugs do have side effects, for example, heartburn, ulcers, nausea or bleeding problems. They are also associated with a higher risk of heart attack or stroke, so should be taken with care and only on the advice of a physician. Melatonin and nerve pain medications can also alleviate symptoms.

Preventing an Ice Pick Headache

The medications mentioned above may work in a preventative capacity, as well. Also, changes to one’s lifestyle may help to prevent many types of headaches and migraines. Getting enough sleep, avoiding alcohol, eating a healthy diet, and generally taking measures to reduce stress can all result in positive effects.

Prognosis

These types of headaches on their own are not dangerous, and although they can be painful, they do not appear to cause any adverse effects in themselves. Some people may be genetically predisposed to this and other types of headaches, which mean they may not go away. However, in many instances, ice pick headaches spontaneously stop occurring.

Prevalence

Ice pick headaches tend to affect women more than men. There is some debate about the prevalence of the condition, possible because they often go undiagnosed given their fleeting nature. The prevalence rate for these types of headache may be anywhere between 2% and 35% of the population.

History of Ice Pick Headaches

Experts first wrote about ice pick headaches in 1964. The condition was known at the time as ophthalmodynia periodica. These headaches have had various names since then, such as primary stabbing headaches, jabs and jolts syndrome, and needle-in-the-eye syndrome. The current term utilized by the International Classification of Headache Disorders is “primary stabbing headache.”

Similar Conditions to Ice Pick Headaches

Ice pick headaches are similar to migraines and cluster headaches. These are some of the conditions doctors will try to rule out during diagnosis. Paroxysmal hemicranias cause severe pain and throbbing lasting up to 30 minutes, sometimes dozens of times a day. Trigeminal neuralgia is another similar condition where the face experiences severe burning sensations in a similar pattern to ice pick headaches but can occur in rapid succession for up to two hours. Occipital neuralgia mimics cluster headaches and migraine and causes similar shooting pains.