Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
An ice pick headache (ophthalmodynia periodica) causes a stabbing pain, much like a sudden jolt, at least once a day.It is now known as primary stabbing headache (PSH) and can occur in both children and adults.
In 80% of the cases, PSH lasts three seconds or less. It also typically moves about, with only about a third of people reporting pain in the fixed location.It’s not clear how many people have ice pick headaches because they tend to be underreported.
This article discusses treatment options and preventive measures, including the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief and lifestyle measures to improvesleepand reduce stress.
Cecilie_Arcurs / Getty Images
Symptoms of an Ice Pick Headache
If you’ve experienced an ice pick headache, you may have felt an intensely sharp jabbing sensation, oftenaround your eyeor temple area. It typically resolves within a few seconds.
People have different experiences with these primary stabbing headaches and it’s not clear how often they occur. A 2022 study of 1,857 people with headache symptoms found just 32 had a final PSH diagnosis. Of these 32 people:
Of this group, 17 started treatment for their symptoms and 10 reported improvement. The people who had pain at a localized site appeared to respond better to treatment.
Causes of Ice Pick Headaches
Ice pick headaches can have several different causes, often due to an underlying health condition. In some cases, there appears to be a hereditary link and family history.
Primary Causes
As the name implies, a PSH doesn’t occur in connection with another type of headache or because of another health issue.However, they may be more common in people who also experiencemigraineheadaches.
Secondary Causes
In some cases, the ice pick headache symptoms you experience follow another health condition, with possibilities ranging fromshinglesto abrain tumor.Headaches due to another diagnosis tend to fall into four categories of disease:
Some research suggests a relationship to cranial trauma, benign cranial lesions, theherpes virus, a disease of the blood vessels in the brain, or nerve sensitization.At this time, though, there is no conclusive scientific data to support any one particular connection.
Cranial Nerve Damage From Head Trauma
Migraine Headaches
Cluster Headaches
Ice pick headaches are also linked withcluster headaches. They are a type of primary headache that causes severe, disabling pain around a person’s eye or near their temple, typically on one side.
One key difference is that cluster headaches last longer than an ice pick headache. Diagnosis also includes symptoms ofnasal congestion,swollen eyelids, tears, facial sweating, and agitation.
Ice Pick vs. Other Headache TypesIce pick headaches have some characteristics that are different from other common types of headaches. A main feature is that an ice pick headache usually resolves in a few seconds without treatment, where a migraine can last for days and needs intervention. It doesn’t have the same patterns of co-occurring symptoms that you might see with other headaches, such as a tension-type headache causing dull rather than sharp pain or nasal congestion with a cluster headache.
Ice Pick vs. Other Headache Types
Ice pick headaches have some characteristics that are different from other common types of headaches. A main feature is that an ice pick headache usually resolves in a few seconds without treatment, where a migraine can last for days and needs intervention. It doesn’t have the same patterns of co-occurring symptoms that you might see with other headaches, such as a tension-type headache causing dull rather than sharp pain or nasal congestion with a cluster headache.
Tension Headache vs. Migraine: What Are the Differences?
Temporal Arteritis
Temporal arteritis, sometimes calledgiant cell arteritis, is an inflammation that typically affects the temples and carotid arteries. It is a serious condition and requires immediate treatment.
A sudden headache is a common symptom but others, including vision loss, occur in people experiencing temporal arteritis.Strokeand other complications need to be prevented.
Intracerebral Meningioma
Intracerebral meningiomasoccur when tumors form in themeningeslayerof the brain.Most of these tumors are benign but even when not cancerous, they can be life-threatening if they grow to large size.
A person with an intracerebral meningioma may experience headaches, but alsoseizures,hearingor vision changes, cognitive changes, and evennauseaand vomiting.
Bell’s Palsy
Bell’s palsyis a paralysis that occurs suddenly on one side of the face, with noticeable changes like a drooping mouth corner or eyebrow. Unlike a stroke, it typically self-resolves after a few months.
A 2019 study of more than 45,000 people found that migraine headaches may increase the risk of Bell’s palsy.Stabbing ice pick headaches also are common with the condition.
Shingles
Autoimmune Disorders
What Are Autoimmune Diseases?
Diagnosing an Ice Pick Headache
Diagnosis of an ice pick headache is generally straightforward due to the unique pattern of symptoms. However, your PSH may occur with other symptoms that require diagnosis. it’s common to rule out possible underlying causes for which your healthcare provider may order tests.
For example, when the headache stabs are fixed on one spot, a headache specialist first must rule out acranial nerveproblem or brain structural problem (like a tumor) with imaging tests.
When to Worry About a Headache
Some headache types cause more concern than others. You should contact your healthcare provider for an evaluation if:
When Should You Worry About a Headache?
Treatment for an Ice Pick Headache
Due to the short-lived nature of these headaches, treatment may not be needed, unless they are severe. In that case, preventive therapy is recommended.
When treatment is necessary, the options include:
Your ice pick headache may be treated along with a co-occurring condition, like cluster headaches treated with oxygen administration, corticosteroids, and other interventions.
Self-Care for an Ice Pick Headache
Since ice pick headaches often coincide with other types of headaches, self-care strategies may be helpful in soothing your pain.
Some simple home-based strategies include:
You also may consider alternative therapies like acupuncture or yoga.
Keeping a Headache DiaryAnother way to understand your ice pick headaches is to keep a descriptiveheadache diary, which can provide your healthcare provider with an accurate account of your head pain. The diary can also help people with stabbing headaches notice what activities may be contributing to their headaches, and what medication seems to soothe them.
Keeping a Headache Diary
Another way to understand your ice pick headaches is to keep a descriptiveheadache diary, which can provide your healthcare provider with an accurate account of your head pain. The diary can also help people with stabbing headaches notice what activities may be contributing to their headaches, and what medication seems to soothe them.
Which Pressure Points Get Rid of Migraines?
Summary
Ice pick headaches are not common, but if you experience them, they are painful and can be burdensome. For many people, their ice pick headaches are so short-lived and not persistent that treatment may not even be necessary. For others, treatment options are available.
Regardless, be sure to see a headache specialist for a properdiagnosis of your headaches. There are other very serious health conditions that mimic symptoms of an ice pick headache, and those need to be ruled out first.
What Is a Headache Specialist and Do You Need One?
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ziegeler C, Daneshkhah S, May A.Stabbing facial pain reminiscent of primary stabbing headache.Cephalalgia. 2020 Sep;40(10):1079-1083. doi: 10.1177/0333102420923643.
Reimers M, Bonemazzi I, Brunello F, Cavaliere E, Sartori S, Toldo I.Primary Stabbing Headache in Children and Adolescents. Life (Basel). 2024 Feb 2;14(2):216. doi: 10.3390/life14020216.
International Headache Society.ICHD-3 4.7 Primary Stabbing Headache.
Cabral G, Saraiva M, Serôdio M, Serrazina F, Salavisa M, Fernandes M,et al.Clinical pattern and response to treatment of primary stabbing headache: Retrospective case series study from a Portuguese tertiary hospital.Headache. 2022 Sep;62(8):1053-1058. doi: 10.1111/head.14377.
Ahmed M, Canlas J, Mahenthiran M, Al-Ani S.Primary stabbing headache in children and adolescents.Dev Med Child Neurol. 2020 Jan;62(1):69-74. doi: 10.1111/dmcn.14357.
Rizzoli P, Mullally W.Headache.Am J Med. 2018;131(1):17-24. doi:10.1016/j.amjmed.2017.09.005
Johns Hopkins Medicine.Primary Stabbing Headache.
Robbins MS.Diagnosis and Management of Headache: A Review.JAMA. 2021 May 11;325(18):1874-1885. doi: 10.1001/jama.2021.1640.
Lee M, Chu MK, Lee J, Yoo J, Song HK.Field testing primary stabbing headache criteria according to the 3rd beta edition of International Classification of Headache Disorders: a clinic-based study.J Headache Pain. 2016;17:21. doi:10.1186/s10194-016-0615-z
Dodick DW.Diagnosing Secondary and Primary Headache Disorders.Continuum (Minneap Minn). 2021 Jun 1;27(3):572-585. doi: 10.1212/CON.0000000000000980.
Hernández P, Al Jalbout N, Matza M, Kohler MJ, Shokoohi H.Temporal Artery Ultrasound for the Diagnosis of Giant Cell Arteritis in the Emergency Department.Cureus. 2023 Jul 24;15(7):e42350. doi:10.7759/cureus.42350.
American Association of Neurological Surgeons.Meningiomas: classifications, risk factors, diagnosis and treatment.
MedlinePlus.Bell palsy.
Kim SY, Lee CH, Lim JS, Kong IG, Sim S, Choi HG.Increased risk of Bell palsy in patient with migraine: A longitudinal follow-up study.Medicine (Baltimore). 2019 May;98(21):e15764. doi: 10.1097/MD.0000000000015764.
American Migraine Foundation.Primary stabbing headache (ice pick headache).
Ngonga GK, Carli D, Zavarise P, Vollaro S, Dalla Volta G.New therapeutic approach to primary stabbing headache.OALibJ. April 2016; 3(4):1-4. doi:10.4236/oalib.1102529
Bermúdez salazar M, Rojas cerón CA, Arana muñoz RS.Prophylaxis with melatonin for primary stabbing headache in pediatrics: a case report.Colomb Med. 2018;49(3):244-248. doi:10.25100/cm.v49i2.3857
NCCIH.Melatonin: what you need to know.
Migraine Research Foundation.Non-drug treatments for migraine.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
