If you’ve ever felt a sudden, stabbing pain in your head—almost like being jabbed with an ice pick—you might have experienced an ice pick headache. These sharp, intense headaches come out of nowhere and vanish just as quickly, leaving many people alarmed and wondering what just happened. While unsettling, these headaches are typically not dangerous. However, understanding their patterns, possible causes, and treatment options can help ease concerns and manage symptoms effectively.
These headaches were first referred to as “ophthalmodynia periodica,” because an ophthalmologist had a patient whose headache pain was in his eyes, but an ice pick headache can occur anywhere. To learn more, Bottom Line Health spoke to Brian M. Grosberg, MD, Director, Hartford HealthCare Ayer Neuroscience Institute Headache Center and a professor of neurology at the University of Connecticut School of Medicine.
Ice pick headaches occur in people of all ages and occur in 2 to 35 percent of the population. Men and women are equally affected.
According to the diagnostic guidelines of The International Classification of Headache Disorders, doctors diagnose ice pick headaches when:
- The head pain occurs spontaneously as a single stab or a series of stabs.
- Each stab lasts for up to a few seconds.
- Stabs recur with irregular frequency, from one to many per day.
- There are no cranial autonomic symptoms.
- The headache cannot be better accounted for by another accepted headache diagnosis.
How long do ice pick headaches last?
For most people—about 80 percent—each headache lasts just a few seconds. But others may experience the headache for up to 2 minutes. The pain can be sporadic or occur in clusters, and the location of the headache can change with each jab or jolt. Some people get multiple ice pick headaches per day, reaching dozens or hundreds of attacks. Others have multiple bouts of pain sequentially over days or longer that then resolves spontaneously, or intermittent episodes that occur over days.
Ice pick headache causes are a mystery, but health-care providers know that people who get migraine attacks or cluster headaches get ice pick headaches more frequently than the average person does.
Is ice pick headache dangerous?
One of the most common questions is: Is ice pick headache dangerous? The short answer is no, in most cases. These headaches are generally harmless, but they can be alarming—many people mistake them for a stroke or another serious neurological condition.
Still, Dr. Grosberg advises all people who have ice pick headaches to be evaluated by a neurologist/headache specialist. In rare cases, they can be the sign of an underlying neurologic issue. Also, if your ice pick headache feels different than those experiences previously, it’s a good idea to check in with your health-care provider.
Triggers
Unlike migraines, ice pick headaches do not have well-defined triggers. This unpredictability can be frustrating for those who experience them. However, individuals who suffer from both migraines and ice pick headaches may have an easier time identifying potential triggers since migraine triggers are more commonly known.
Ice pick headache treatment
Because the pain is so brief, it usually resolves before a person has time to take a pain reliever. And although ice pick headaches can occur once or several times per day, pain relievers will not prevent them.
For patients who experience many painful ice pick headache episodes, Dr. Grosberg recommends the nonsteroidal anti-inflammatory drug indomethacin. It is commonly used to treat mild to moderate acute pain and relieve symptoms of arthritis, and it has had proven success in ice pick headaches. Other options include gabapentin, cyclooxygenase-2 inhibitors, and melatonin.
