Ice pick headaches typically involve stabbing pain that lasts only a few seconds. Some people, including those with migraine, may be more likely to experience them.

Ice pick headaches, known officially as primary stabbing headaches, are painful, severe headaches that come on suddenly.

They’re often described as feeling like a stabbing blow, or a series of stabs, from an ice pick. They give no warning before striking and can be excruciating and debilitating. They’re also brief, typically lasting only a few seconds.

Ice pick headaches can occur at any time during sleeping or waking hours. They may also happen multiple times within a day and affect different parts of your head.

Ice pick headaches are also called:

  • primary stabbing headaches
  • idiopathic stabbing headaches
  • jabs and jolts
  • opthalmodynia periodica
  • short-lived head pain syndrome
  • needle-in-the-eye syndrome

Read on to learn more about ice pick headaches, including typical symptoms, causes, and treatment options.

Ice pick headaches are categorized by several symptoms. These include:

  • sudden, stabbing head pain, which typically lasts around 3 seconds
  • rarely, pain that lasts 10 to 120 seconds or longer
  • pain that may be categorized as moderately severe to extremely painful
  • stabs that occur once or many times in waves over several hours
  • stabs that occur 50 times per day or more
  • stabs that occur without warning
  • pain that’s typically felt on the top, front, or sides of the head
  • stabs that occur in multiple areas of the head, one at a time
  • pain that can affect one or both sides of your head

Ice pick headaches are sometimes associated with cluster or migraine headaches, but they vary from these types. Their symptoms don’t include any involuntary signs like:

  • facial flushing
  • eyelid drooping
  • tearing

Ice pick headaches vs. migraine attacks

Migraine attacks are intense, debilitating headaches. They last longer than ice pick headaches, sometimes lingering for hours or days.

Migraine pain usually occurs only on one side of the head and may be preceded by a wide range of symptoms, including:

  • facial tingling
  • blind spots
  • flashes of light, known as a visual aura

Migraine episodes are often accompanied by nausea, vomiting, and heightened sensitivity to light or sound.

Ice pick headaches vs. cluster headaches

Cluster headaches are severe headaches that occur in clusters. They often occur during sleep, affecting the area around one eye or on one side of the head.

Like ice pick headaches, they strike suddenly but are often preceded by migraine symptoms or by a migraine attack.

As their name suggests, they may occur in clusters over an extended period of time, ranging from weeks to months. In addition to extreme pain, symptoms include:

  • tearing and redness of one eye
  • a drooping eyelid
  • swelling around the eye
  • a stuffy or runny nose

Ice pick headaches also differ from tension headaches, which generate mild to moderate pain and may surround the entire head like a vice.

The underlying cause of ice pick headaches is currently unknown but is thought to be associated with fleeting, short-term disruptions within the brain’s central pain control mechanisms.

Although ice pick headaches were thought to be relatively rare, newer research indicates that they occur in 2 to 35 percent of the population and more often in women than men.

A 2017 study found that within a group of 65 people admitted to Samsung Medical Centre Headache Clinic with ice pick headaches, the age range was between 25 and 83 with a median age of 54.

People who get migraine attacks or cluster headaches get ice pick headaches more frequently than the average person does.

Like ice pick headaches, cluster headaches don’t have any specific known triggers. People who get migraine attacks, as well as ice pick headaches, may have more success in determining their triggers. These can include:

Ice pick headaches are sometimes categorized as primary headaches, meaning they’re caused by the headache condition and not by another associated diagnosis. They may also be categorized as secondary headaches with an underlying cause.

These causes include conditions, such as:

  • Migraine. People who get migraine attacks are more likely to get ice pick headaches than others. They may also get ice pick headaches in the same area of the head where their migraine attacks occur.
  • Cluster headaches. Ice pick headaches sometimes occur at the end of a cluster headache cycle.
  • Temporal arteritis. This condition affects the arteries that supply blood to the head and brain. If left untreated, it can lead to stroke, a brain aneurism, or death.
  • Intracerebral meningioma. This is a slow-growing tumor, which may occur on the brain’s surface or on the spinal cord. These types of tumors can affect various areas of the brain. Treatment options include radiation, observation, and surgery.
  • Autoimmune disorders. One small study from 2012 found a link between autoimmune disorders, such as multiple sclerosis, lupus, and autoimmune vasculitis, with ice pick headache occurrence.
  • Bell’s palsy. Bell’s palsy is a form of temporary facial paralysis resulting from damage or trauma to the facial nerves.
  • Shingles. Shingles is a viral infection of nerves and can lead to secondary ice pick headaches.

Ice pick headaches are so brief in duration that they often don’t provide a window of opportunity to take medication.

However, if you’re prone to frequent attacks, prophylactic use of pain-reducing medication may make sense for you. Prophylactic medications are medications you can take to prevent headaches.

You can speak with your doctor to find out which type of medication will be best for you.

You and your doctor can consider the following drugs:

  • Indomethacin. An oral nonsteroidal anti-inflammatory drug (NSAID), indomethacin blocks inflammation, reducing pain. It’s a prescription medication often used to treat headaches, including ice pick headaches and migraine headaches. About 35 percent of people with ice pick headaches don’t respond to this medication.
  • Melatonin (N-acetyl-5 methoxy tryptamine). The hormone melatonin is available without a prescription. It’s used to reduce insomnia, as well as headaches.
  • Gabapentin. Gabapentin is a prescription medication used primarily as an anticonvulsant and to treat nerve pain.

It may help to keep a diary, outlining your daily activities, emotions, food intake, and ice pick headache occurrence. Some apps may also help you keep track. If you’re able to identify a specific trigger, avoiding it may help.

Complementary forms of treatment, such as acupuncture, may be effective at reducing migraine attacks and may also help diminish ice pick headache occurrence.

Since ice pick headaches are sometimes associated with other conditions, it makes sense to see a doctor to discuss your symptoms. Other more serious conditions can cause similar symptoms, so it’s important to rule them out.

Despite their severity, ice pick headaches usually aren’t dangerous. They don’t require medical intervention unless they occur frequently or interfere with your daily life. Since they occur without warning, it’s important to do what you can to avoid them if they happen with any type of frequency.

This may be especially important if you operate machinery, drive a vehicle, or engage in any other activity that might cause serious consequences if you experience an unexpected stab of pain.

Ice pick headaches can be difficult to diagnose since they’re often associated with other types of headaches.

Diagnosis is usually made clinically, meaning based on your symptoms. Doctors consider the symptoms and criteria listed in the International Classification of Headache Disorders, third edition when making a diagnosis.

Neuroimaging may be required to rule out other conditions if your headaches are always on the same side or if your symptoms are atypical.

Ice pick headaches may be caused by malfunctions in the brain’s central pain control mechanisms. Women and people with migraine or cluster headaches may be more likely to get ice pick headaches than others.

Ice pick headaches aren’t dangerous but can be debilitating. If they affect your quality of life, you can speak with a doctor about medications or treatments that may help.